Another recent review by Do et al. reported outcomes following laparoscopic MAL release in 16 patients over a 6-year period [10]. Twelve patients were treated with a laparoscopic approach and four patients underwent a robotic-assisted approach. The most common presenting symptom was postprandial abdominal pain. Other symptoms included nausea, vomiting, and weight loss. Five patients had an abdominal bruit on physical examination. The majority of patients laparoscopically treated were women (75 %), and the majority of patients robotically treated were men (75 %). Mean operative times were shorter for the laparoscopic group compared with the robotic-assisted group (101.7 min vs. 145.8 min; p = 0.2). There was no significant difference in hospital length of stay between the two groups. Eight patients (67 %) in the laparoscopic group and two patients (50 %) in the robotic-assisted group had full symptomatic improvement.

Successful outcomes have also been reported following laparoscopic treatment of MALS in the pediatric population. The peer-reviewed literature is currently limited to two series (excluding case reports) reporting outcomes for MALS in children [11, 12]. In a recent review by Mak and colleagues, 46 pediatric patients (mean age 16.2 ± 0.5 years) underwent laparoscopic release of the MAL [11]. In their series, the condition was more common in females (91 %) than males. Patients were screened with preoperative duplex and subsequent CTA if celiac artery compression was present on noninvasive imaging. Overall, 67 % of patients reported improvement of symptoms following their operation. No intraoperative conversions were required and there were no deaths reported in the series.

In another series by Joyce et al., six patients underwent laparoscopic treatment for MALS over a 3-year period [12]. Similar to Mak’s study, the majority of patients were female (83.3 %) with an average age of 15.7 ± 1.5 years. The most common symptoms were postprandial pain (83.3 %) and nausea/vomiting (83.3 %). Other presenting symptoms included epigastric pain (50 %), pain elevated with action (33.3 %), increased bowel activity (16.7 %), and diffuse abdominal pain (16.7 %). Mean operative time and hospital length of stay were 172.5 min and 1.3 days, respectively. Mean peak celiac artery flow (cm/s) was 332.0 preoperatively and decreased to 224.3 postoperatively. A significant improvement from pre- to postsurgical scores was observed in the physical functioning (p = .03), mental health (p = .03), and self-esteem categories (p = .03) of the child assessment. Similarly, there was a significant postsurgical improvement in all categories pertaining to the parent’s quality of life (p = .03). Improvement was also seen in the parents’ perception of their child’s physical functioning (p = .03), bodily pain/discomfort (p = .03), mental health (p = .03), and general health perceptions (p = .03). No intraoperative or postoperative complications occurred. No patient required celiac artery reconstruction and/or revascularization.