Robotic-assisted"3+1"Surgical Mode Strategy for 6 Cases of Median Arcuate Ligament Syndrome
Objective To investigate the feasibility of robotic-assisted"3+1"surgical mode strategy for the treatment of median arcuate ligament syndrome(MALS).Methods Six patients diagnosed as MALS were enrolled between June 2019 and October 2023.The utilization of robotic-assisted"3+1"surgical mode(a 4-hole operation with 3 robot arms and 1 assistance hole)was carried out.Through a posterior splenic artery approach,the compression of the midline arcuate ligament on the abdominal trunk was relieved,which was an abdominal trunk vascularization.Results All the 6 patients underwent robotic-assisted"3+1"surgical mode successfully.The surgical duration(including the time for connecting and disconnecting the machine)was 38-52 min,with a mean of 43.2 min.The intraoperative bleeding volume was 5-25 ml,with a mean of 15 ml.The postoperative hospital stay was 6-9 d,with a mean of 7.5 d.All the 6 patients were followed up for 1-45 months after surgery(median,2.5 months).One patient remained unchanged in body weight,while 5 patients gained 1.0-2.0 kg in body weight,with a mean of 1.5 kg.The symptom of postprandial epigastric pain completely resolved in 5 patients,while the symptom was reduced but not completely alleviated in one patient.Conclusion Treatment of MALS with the robotic-assisted"3+1"surgical model involving abdominal trunk vascularization through a posterior splenic artery approach is safe and feasible.
Median arcuate ligament syndromeRobotic-assisted surgery
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