title: Medial arcuate ligament: a new anatomic landmark facilitates the location of the renal artery in retroperitoneal laparoscopic renal surgery.
abstract: OBJECTIVE
  The purpose of this study was to introduce a new method for locating the renal artery during retroperitoneal laparoscopic renal surgery.
  
  
  METHODS
  The medial arcuate ligament (MAL) is a tendinous arch in the fascia under the diaphragm that arches across the psoas major muscle and is attached medially to the side of the first or the second lumbar vertebra. The renal artery arises at the level of the intervertebral disc between the L1 and L2 vertebrae. We evaluate the role of the MAL that serves as an anatomic landmark for locating the renal artery during retroperitoneal laparoscopic renal surgery.
  
  
  RESULTS
  There is a reproducible consistent anatomic relationship between MAL and the renal artery in 210 cases of retroperitoneal laparoscopic renal surgery. Two main types of the MAL, the "narrow arch" and the "fascial band" types, can be observed.
  
  
  CONCLUSIONS
  MAL can serve as an accurate and reproducible anatomic landmark for the identification of the renal artery during retroperitoneal laparoscopic renal surgery.
authors: Department of Urology, Chinese PLA General Hospital, Beijing, China.
authors: Wei
authors: W
authors: Cai
authors: Hong Zhao
authors: HZ
authors: Li
authors: Xu
authors: X
authors: Zhang
authors: Yong
authors: Y
authors: Song
authors: Xin
authors: X
authors: Ma
authors: Jun
authors: J
authors: Dong
authors: Wenzheng
authors: W
authors: Chen
authors: Guang-Fu
authors: GF
authors: Chen
authors: Yong
authors: Y
authors: Xu
authors: Jin Shan
authors: JS
authors: Lu
authors: Bao-Jun
authors: BJ
authors: Wang
authors: Tao-Ping
authors: TP
authors: Shi
mesh_terms: D000328:Adult; D059925:Anatomic Landmarks; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008022:Ligaments / Q000033:anatomy & histology*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012077:Renal Artery / Q000033:anatomy & histology*; D015203:Reproducibility of Results; D012187:Retroperitoneal Space / Q000601:surgery*