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Robotic-Assisted Release of the Median Arcuate Ligament for Pediatric MALS

Video Published 2021-01-25 Updated 2026-05-25

Topic Overview

Presented by Alejandra M Casar Berazaluce, MD; Alexander Gibbons, MD; and Jaimie D Nathan, MD from Cincinnati Children's Hospital Medical Center at the IPEG - International Pediatric Endosurgery Group 28th Annual Congress for Endosurgery in Children.

Scientific Video Session l: Coolest Tricks
Moderators: Carroll Harmon, MD & Holger Till, MD


Median Arcuate Ligament Syndrome is a chronic abdominal pain syndrome characterized by epigastric pain, nausea, and vomiting that leads to anorexia and weight loss. It is a diagnosis of exclusion, hypothesized to be caused by compression of the celiac artery and celiac plexus by the median arcuate ligament at the junction of the right and left diaphragmatic crura. Due to the presence of an identifiable mechanical constriction, the management of MALS is surgical. In this video, we present the key features of the robotic approach for its release in the pediatric population.

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