To Cut or Not To Cut: That is One Huge Question

NOVEMBER 16, 2010/ 2:34 AM

POSTED BY BRITTANY CURRAN

A SENIOR AT STEPHENS COLLEGE

To correct MALS  , a doctor has to cut the median arcuate ligament to relieve the pressure that it is putting onto the celiac artery and to increase the blood flow. However, cutting the ligament does not always automatically resolve the issue. Sometimes, the artery does not always re-inflate, so the doctor may also have to put in a stint to open the artery back to how it should be. Dr. Thompson also said, that he has realized that when trying to end the chronic pain caused by MALS, he also needs to remove the damaged nerves on the artery. These nerves are what keep sending messages to the brain saying that I am in pain.

After meeting with Dr. Thompson, I learned that I had one difficult decision to make on how to correct MALS. There are two options that are similar and yet so different to a person’s body. They are: 1) Laparoscopic Surgery; and 2) Open Surgery. Laparoscopic surgery consists of the doctor making five millimeter incisions in various spots on my stomach. These incisions would just be big enough for the doctor to get the tools necessary into the body to cut the ligament and possibly put a stint in if it is necessary.

The other option is open surgery, which is when the doctor will make an incision from a person’s diaphragm down to their belly button, and sometimes the doctor will even go a little further than that. This surgery is more of a guarantee that MALS is going to be corrected. This option gives the doctor the visibility to make sure that he has cut and removed the ligament, removed the scar tissue, and the damaged nerves. Then, if necessary, he will put the stint in if the artery does not inflate on its own.

The downside to laparoscopic surgery is there is no guarantee that the surgery is going to be completely successful. Sometimes, patients that have had laparoscopic surgery end up coming back later and have the open surgery because the laparoscopic surgery did not allow the doctor enough visibility to remove all the damaged scar tissue. Also, sometimes the celiac artery sits so high up on the aorta, if a stint needs to be put in; it is difficult to put it in the right place.  However, with the open surgery, you will have a scar going down your stomach forever, but you will only have to do this procedure once which is definitely a positive aspect.

When I was told that I had to have this surgery, I did not even comprehend everything being said to me because I was still stuck on the word surgery. It is definitely one of the scarier words in the English language. Just the thought of surgery is scary, but at the same time the thought of never having this stomach pain again, now that is pretty exciting. The scar I can live with.