MALS surgery success rates: what every published study reports

"Will surgery help me?" is the question most people with median arcuate ligament syndrome (MALS) ask. Single hospitals publish their own results, and the numbers vary a lot. We read the abstracts of every MALS paper in PubMed that reports treatment results and put the numbers side by side, so you can see the whole picture, not one hospital's.

Results by type of operation

"Improved (weighted)" counts every patient once, so large studies count more. "Median study" is the middle value when studies are lined up from lowest to highest success.

Keyhole (laparoscopic) and robotic operations have largely replaced open surgery. Differences between approaches in this table come from different hospitals, patients and definitions of success, not from head-to-head comparisons; a 2026 meta-analysis that compared laparoscopic and robotic release found similar results [PubMed].

All studies

Filter by treatment or age group. Each title opens the study in PubMed. "Improved" is the share of treated patients with symptom relief as that study defined it; the definition is shown under the title.

Treatment AllOpen surgeryRoboticLaparoscopic (keyhole)Surgery, approach not statedSeveral surgical approachesEndoscopic retroperitonealCeliac plexus block / neurolysis Patients All agesAdultsChildren and teens only studies with a success rate

Extracted by our editors from the PubMed abstracts of 259 MALS papers screened (98 report treatment outcomes), built November 8, 2026. Every number was checked against a verbatim quote from the abstract.

How we built this

• We searched PubMed for all papers on median arcuate ligament syndrome and celiac artery compression syndrome, then screened those that mention treatment and are not single case reports.
• For each study we recorded the number of treated patients, the operation, follow-up, the share of patients who improved, complications and conversion to open surgery, only as stated in the abstract.
• Every number is stored with the exact sentence from the abstract that supports it, and a script checks that the sentence and the number really are there. Values that failed the check are left out.
• Systematic reviews are listed in PubMed but not added to the totals, to avoid counting the same patients twice.

Limitations

• Abstracts are short; the full papers may contain details we did not capture.
• Studies define improvement differently and follow patients for different lengths of time.
• Hospitals with good results are more likely to publish, so published success rates may be higher than in everyday practice.
• Some hospitals published several papers about overlapping groups of patients.
• These are averages. Your own chance of improvement depends on your symptoms, test results and the experience of your team.

Questions to ask your surgeon

• What share of your own patients improve, and how do you define improvement?
• How many of them still feel better one and five years later?
• What tests do you use to predict who will benefit, such as a celiac plexus block?
• What happens if my symptoms do not improve or come back?

See also: MALS surgery explained, long-term outcomes, hospitals with published experience and our printable questions for your doctor.

MALS Compass is an independent educational website, not a medical provider, and is not affiliated with any hospital, clinic or university. This page is educational information and does not replace advice from your own doctor. For any question about your health, please contact your doctor or an official healthcare institution.