What to Expect Before, During, and After MALS Surgery

Are you experiencing frequent symptoms of nausea, abdominal discomfort, and vomiting? These could be signs of Median Arcuate Ligament Syndrome (MALS). MALS can occur when the celiac blood vessel becomes compressed due to the medial arcuate ligament, decreasing blood flow into abdominal organs. While rare, MALS may cause discomfort and pain for those suffering.

MALS surgery may relieve symptoms of celiac compression by relaxing the artery compressed by celiac compression. The process can be intimidating, and patients should know the procedure before, during, and after the procedure.

Exploring MALS Surgery

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

Before the Procedure

  • Consultation with a Surgeon: Your first step should be arranging an appointment with a surgeon specializing in the procedure. In this appointment, they will review your medical history and symptoms of chronic abdominal pain before ordering imaging tests to confirm the MALS diagnosis. If they decide that you are a potential candidate for MALS surgery, they will discuss the possible risks and benefits of MALS.
  • Pre-Operative Preparation: When you’ve decided to go through MALS surgery, your surgeon will provide preparation instructions. This may involve eating healthy food before surgery, discontinuing certain medications, and avoiding certain foods or drinks. Before the surgery, they suggest pre-operative testing, including blood tests and an electrocardiogram.

During the Procedure

  • Anesthesia: MALS procedures are performed under general anesthesia, meaning you’ll remain asleep. An anesthesiologist is present during the procedure to observe vital signs and ensure that you are in good health.
  • Cut: Surgery will make a small incision to access the celiac vein, which MALS compresses. It can be done vertically or horizontally, depending on their preferred placement and the desired outcomes.
  • Ligament Release: After the procedure, the surgeon will be able to release the median arcuate ligament, compressing the celiac artery, thereby limiting the flow of blood to organs located in your abdomen. To accomplish this release procedure, surgeons may reduce or remove a small portion before opening it to allow for the proper functioning of the celiac artery and better blood flow to abdominal organs and internal organs.
  • Closing: Once the ligament is released, a surgeon will close the incision using staples or sutures and then insert the drain in a small area to catch any fluid accumulating.

After the Procedure

  • Hospitalization: You will be carefully checked. Any discomfort caused can be addressed with medication. You will be urged to stand and move around as soon as possible to prevent blood clots.
  • Following Surgery: You need to take it slow and see your surgeon frequently to ensure that you’re recuperating correctly. Avoid any physical exercise or heavy lifting until advised to do it is recommended.
  • Lang-Term Perspective: Most sufferers who underwent MALS surgery, a long-lasting solution for MALS, can experience significant relief from their symptoms. However, any surgery could be a risk for bleeding infections or organ damage that must discuss with the surgeon before commencing any procedure.


MALS surgery can offer much-needed relief for those with median arcuate ligament disorder. While the procedure is not without risk, some find its advantages outweigh them. If you’re considering MALS operation as a source of relief, speak with an experienced surgeon specializing in it for the best advice and information before making your decision.