Median Arcuate Ligament Syndrome (MALS) occurs when the celiac artery (the artery below that diaphragm that stems from the aorta) becomes compressed by the median arcuate ligament. When the median arcuate ligament is restricted, the blood flow is limited to the digestive system which can ultimately lead to significant abdominal pain.

Common Symptoms of MALS

Patients experiencing MALS will typically have stomach pain soon after eating. Unfortunately, the only way to prevent pain is to limit or avoid eating, which can cause additional conditions. Patients may also have:

  • Pain
  • Nausea
  • Weight loss
  • Exhaustion, particularly after a heavy meal
  • Inability to exercise

Treatment of MALS

Our vascular surgeons provide a minimally invasive treatment for MALS by laparoscopically releasing the ligament to restore blood flow, which results in shorter hospital stays, less pain and a quicker return to daily activities.

Frequently Asked Questions About MALS Surgery

The surgery will be done utilizing laparoscopic technique. Five to six laparoscopic incisions will be made in the abdomen. The median arcuate ligament will be released and we will obtain a repeat duplex ultrasound in the operating room to confirm that the blood flow has normalized. Once the surgeon is satisfied that the blood flow has been normalized, the surgery is complete.

Patients will be admitted to the hospital after surgery. The average stay in the hospital is approximately four days. Once you're tolerating a regular diet, your pain is well controlled with oral pain medications and you can walk without assistance, you will be discharged home.

Care of the incisions: The laparoscopic sites will have a shiny substance over them called Dermabond. Although we will allow bathing within a few days after surgery, the Dermabond over the incisions should not be scrubbed off or removed. The Dermabond will disappear on its own. This may take several weeks.

Activity: You should not do any heavy lifting, strenuous activity or sports until you are cleared by the surgeon.

Diet: You can eat a regular diet; however, it is recommended that you eat several small meals, rather than a few large meals. Constipation is common after surgery. Anesthesia and pain medication can contribute to constipation. You should drink plenty of water and avoid beverages with caffeine or alcohol in them.

Medication: It is important to take the pain medications as directed by the surgeon. If the pain is not under control, you should contact your physician.

Call us if there are any questions or if there is bleeding or drainage from the incision sites, fever over 101F, vomiting or a decrease in urinary output.

Our MALS Physician Team

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