The Road to Recovery: What to Expect About MALS Surgery

Are you experiencing frequent abdominal pain, nausea, and vomiting? These could be signs of Median Arcuate Ligament Syndrome (MALS). MALS is a condition that occurs when the celiac artery becomes stretched by the medial arcuate ligament, reducing the flow of blood to abdominal organs. Although rare, MALS can cause discomfort and pain for those affected.

MALS surgery can relieve the symptoms of celiac compression by relaxing the artery that is compressed by celiac compression. Every surgery is a challenge, and patients should know what to expect before the procedure, throughout, and after.

Exploring MALS Surgery

This post will review the steps involved with MALS surgery – preparation for the procedure, the actual procedure, and the post-op recovery.

Before the Procedure

  • Consultation with a Surgeon: Before you begin MALS treatment, the initial step is to schedule an appointment with a specialist surgeon for this procedure. At this consultation, they will examine your symptoms and medical history before ordering imaging tests that confirm the MALS diagnosis. If they determine that you’re a suitable candidate to undergo a permanent treatment option for MALS, they will discuss this procedure’s possible risks and advantages.
  • Pre-Operative Preparation: Once you decide to undergo MALS surgery, your surgeon will offer instructions on preparation. It may include fasting for a certain amount of time before your robotic abdominal surgery, discontinuing certain medications, or avoiding certain beverages or food items. Before the procedure, they may recommend undergoing pre-operative tests such as blood work and an electrocardiogram.

During the Procedure

  • Anesthesia: MALS procedure is performed under general anesthesia, meaning you will fall asleep. An anesthesiologist will be on hand throughout the surgery to watch vital signs and ensure you remain comfortable.
  • Cut: Your surgeon will create a tiny incision to access the celiac artery, which MALS compresses. This could be vertically or horizontally, depending on their preference and desired outcomes.
  • Ligament Release: After the procedure, the surgeon will release the median arcuate ligament. This will compress the celiac vein and limit blood flow to organs within the abdomen. To accomplish this release procedure, the surgeon may cut or trim away part of it before reopening it again for the proper functioning of the celiac artery and better blood flow to abdominal organs.
  • Closure: Once the ligament has been let go, the surgeon will close the incision with staples or sutures and then insert an incision with a drain that will collect any accumulated excess fluid.

After the Procedure

  • Hospitalization: You will be carefully and closely monitored. The discomfort you experience can be treated with medications for pain. You will be advised to get up and move around as soon as possible to avoid problems like blood clots.
  • After Surgery: You must take your time and visit your surgeon regularly to ensure you’re getting the best treatment. Avoiding physical exertion or heavy lifting until instructed to do so might be advised.
  • The Long-Term Prospect: Most who go through MALS surgery feel relief in their symptoms; however, any surgery can pose risks such as bleeding, infection, or organ damage. These risks must consult with your doctor before starting any procedure.


MALS surgery is a great option to relieve those suffering from median arcuate ligament disorder. Although it is not without risks, many people find the benefits outweigh them. If considering MALS surgical procedures to relieve pain, consult an expert in the field for the best guidance and advice before making your decision.