SMA X ALVEAR PROCEDURE

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SMA-Alvear Procedure (Duodenal Derotation)

The SMA-Alvear procedure, also known as duodenal derotation surgery, is a surgical technique developed by Dr. Domingo Alvear for treating Superior Mesenteric Artery (SMA) Syndrome. Dr. Domingo Alvear is considered "the world's leading SMA Specialist" who "has written many medical articles over the years around SMA Syndrome and has pioneered a procedure called the Alvear Procedure or Duodenal Derotation Surgery."

What is SMA Syndrome?

SMA Syndrome is a rare condition where the duodenum (part of the small intestine) becomes compressed between the superior mesenteric artery and the abdominal aorta. This occurs when the fat pad between these vessels is reduced, narrowing the angle to less than 20 degrees and causing duodenal obstruction.

The Alvear Procedure

Duodenal derotation has been evaluated "as a surgical option for superior mesenteric artery syndrome (SMAS) in two groups of young patients" with documented success over a thirty-three year experience.

Other Surgical Options for SMA Syndrome

The traditional surgical approaches for SMA syndrome include:

• Duodenojejunostomy - Laparoscopic duodenojejunostomy is considered "safe and effective" for patients with duodenal obstruction from SMA syndrome
• Strong procedure - This "divides the ligament of Treitz to allow lowering of the duodeno-jejunal junction which can relieve the compression"
• Gastrojejunostomy
• Duodenal anterior replacement

The Alvear procedure appears to be a specialized form of duodenal derotation that has gained recognition for its effectiveness in treating SMA syndrome, particularly in young patients. Dr. Alvear continues to teach this technique to surgeons worldwide.

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