Do You Have MALS?
Median arcuate ligament syndrome, or (MALS), is a rare, complex, under-diagnosed disease that often causes chronic, debilitating pain in the upper part of the abdomen. People with MALS are born with an anatomic abnormality of the their diaphragm and median arcuate ligament, causing the median arcuate ligament to compress the celiac artery, a major branch of the abdominal aorta, and the celiac nerve ganglion and plexus of nerves. This pressure can lead to blood flow changes, as well as nerve entrapment and inflammation, resulting in extreme pain, sitophobia (fear of eating), significant weight loss, constipation and diarrhea.
Once MALS is diagnosed, there are two main treatments that may be recommended. A celiac block injection can offer temporary relief and is commonly used as part of the diagnosis process, but it does not permanently relieve pressure on the celiac plexus nerves or aorta. MALS surgery offers a long-lasting solution to relieve the symptoms of MALS.
Minimally Invasive Robotic MALS Surgery
Dr. Shouhed is uniquely qualified to offer patients innovative robotic surgery as a treatment option for MALS. He has published multiple peer-reviewed articles on MALS and is recognized across the country as one of the authoritative figures on the diagnosis and treatment of MALS. He is not only an expert in the diagnosis and treatment of MALS, but with the superior skill provided by Dr. Shouhed, robot-assisted MAL release can be performed safely and effectively with the avoidance of conversion events and minimal morbidity.
The robotic approach will allow for a very precise and delicate dissection with release of the ligament,” says Dr. Shouhed. In this procedure, 5-6 tiny incisions are made in the abdomen to access the median arcuate ligament and view the tissues through a laparoscope. The ligament is separated and released to relieve compression on the celiac artery of the aorta and irritation of the nerves of the celiac plexus.
MALS surgery usually requires an overnight stay in the hospital for observation, but most patients can return home the next day. Symptoms like abdominal pain after eating are usually relieved immediately after MALS surgery.
If you have been diagnosed with MALS and want to explore permanent treatment options, contact our office in Los Angeles. Our staff can schedule a consultation with Dr. Shouhed to discuss MALS surgery, or median arcuate ligament release.
