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Stamford doctor helps alleviate severe pain through MALS surgery

MALS is a type of vascular compression resulting from a ligament in the chest sitting lower than normal.

Gillian Neff

and

Lauren Pena

Mar 23, 2025, 1:02 PM

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Dr. Richard Hsu, of Stamford Hospital, performs surgeries for patients with Median Arcuate Ligament Syndrome.

The condition is a type of vascular compression resulting from a ligament in the chest sitting lower than normal. This presses against the main blood vessel that supplies blood to the stomach, liver and other organs.

“The pain can be severe enough to stop them from eating,” said Dr. Hsu.

Toby Gilbert’s symptoms began when he was around 9 years old.

“I leaned over to get my swim bag and felt a ripping sensation in my stomach,” he said. “There was like a month I was in the hospital every single week trying to figure out what was wrong with my stomach.”

A CAT scan revealed that he has MALS a year later.

His mother sought the help of Dr. Hsu after learning about him on the internet. Gilbert was his first pediatric case.

After receiving approval to operate, he performed the procedure. While typical MALS surgery involves releasing a main artery being compressed, Dr. Hsu believes it's also necessary to remove damaged nerves that shoot pain signals.

The surgery was a success. Gilbert, now 19 years old, can enjoy life without pain.

MORE: Stamford Hospital surgeon completes 1,000th 'life-changing' abdominal surgery

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