Are you experiencing frequent stomach pains, nausea, and vomiting? These are signs of Median Arcuate Ligament Syndrome (MALS). MALS is a condition that occurs when the celiac artery is constricted by the medial arcuate ligament, restricting the flow of blood into abdominal organs. While rare, MALS may be painful and uncomfortable for patients affected.

MALS surgery can relieve the symptoms of celiac compression by relaxing the artery that is compressed by celiac compression. Surgery can be a daunting experience, and patients need to know what to expect before the procedure, throughout, and after.

Exploring MALS Surgery

This article will go over the steps involved in MALS surgery, including pre-op preparation, the actual procedure, and post-op recovery.

Before the Procedure

  • Consultation with a Surgeon: For those considering the MALS procedure, your initial step is to schedule an appointment with a specialist surgeon trained in the procedure. In this appointment, they will assess your medical history and symptoms before ordering imaging tests to confirm the MALS diagnosis. If they decide that you are an appropriate candidate for MALS surgery, they will go over this procedure’s possible risks and benefits. You can follow this link for more info about MALS treatment and surgery.
  • Pre-Operative Preparation: If you’ve decided to undergo MALS surgery, your surgeon will give you instructions for preparation. It could include eating healthy food before surgery, stopping certain medications, and not eating certain drinks or foods. Before starting, your bariatric surgery specialist may recommend undergoing pre-operative tests like blood tests and an electrocardiogram.

During the Procedure

  • Anesthesia: MALS procedure is performed under general anesthesia, meaning you’ll fall asleep. An anesthesiologist is present during the procedure to observe vital signs and ensure you are comfortable.
  • An incision: The surgeon you choose to consult with will create a small cut to access the celiac artery compressed by the median arcuate ligament. It can be done horizontally or vertically, based on their preferred location and desired outcomes.
  • Ligament Release: After doing this procedure, the surgeon will release the median arcuate ligament, which compresses the celiac artery, limiting blood flow to organs in the abdomen. To accomplish this release procedure, surgeons may remove or cut off a portion of it before reopening it for the proper functioning of the celiac artery and increased blood flow to the abdominal organs internal to the abdomen.
  • Closure: Once the ligament is removed, a surgeon will close the incision with staples or sutures and then place an incision with a drain to collect any excess accumulated fluid.

After the Procedure

  • Hospitalization: You will be carefully watched. Any discomfort can be addressed by taking painkillers. You’ll be advised to get up and move about as quickly as possible to prevent issues such as blood clots.
  • Following Surgery: You must take your time and visit your surgeon regularly to ensure you’re recuperating correctly. Avoid physical activity or heavy lifting until you are instructed to do so is recommended.
  • Lang-Term Perspective: Most people who have Median Arcuate Ligament Syndrome surgery feel relief from their symptoms; However, any procedure can be a risk for bleeding or infection, or organ damage, which must discuss with the surgeon before starting any procedure.


MALS surgery can provide relief for those suffering from median arcuate ligament disorder. While the procedure is not without risk, many people find the benefits surpass the risks. If you are considering the MALS procedure as a method of relief, speak with an expert surgeon to get the best advice and details before deciding.

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