Robotic median arcuate ligament release in a pediatric surgery center.

PURPOSE: Median arcuate ligament syndrome is characterized by chronic abdominal pain due to compression and neurofibrosis of the celiac trunk. While it frequently presents in adulthood, adolescents can be affected. The syndrome is often treated with an open median arcuate ligament release. Robotic surgery has grown in popularity for complex cases to improve visualization and post-operative recovery, however there is limited data on the feasibility and benefits of robotic median arcuate ligament release compared to an open procedure, particularly in a pediatric cohort. METHODS: A retrospective review of a single pediatric surgery center's experience was performed from August 2021 to July 2025, during which time patients underwent open (n = 7) or robotic (n = 10) release of their median arcuate ligament. RESULTS: There was no difference in operative time or complications between the two groups, however, patients who underwent robotic repair had a median length of stay of one day, significantly shorter than those undergoing open repair, with a median length of stay of four days (p = 0.0128). CONCLUSION: Robotic surgery for median arcuate ligament syndrome can be done by robotic-trained pediatric surgeons, which may offer shorter hospital stays without significant operative delays or increased risk of complications.