Purpose: Median arcuate ligament syndrome (MALS) is a rare condition caused by compression of the coeliac artery by fibres of the diaphragm. Robotic-assisted release is an increasingly favoured treatment approach, but the proximity to major vessels introduces risk of arterial injury. There is currently no formal algorithm defining the vascular surgeon’s role in these procedures. This study presents a novel, stepwise, vascular-integrated algorithm to enhance procedural safety. Methodology: A structured operative workflow was developed involving both vascular and general surgical teams. Immediately prior to robotic release, patients have femoral sheath access and preliminary cannulation of the coeliac artery so catheter selection and imaging projection is known in advance of surgery. Ancillary equipment such as occlusion balloons and covered stents are made available for use in the event of bleeding. Robotic division of the median arcuate ligament is performed with vascular surgeons on standby or scrubbed in, enabling immediate intervention if required. This algorithm was prospectively tested in three MALS cases. Results: All three patients underwent successful robotic-assisted release with no intra-operative bleeding or vascular complications. Preoperative sheath placement and catheter selection was uneventful, and no cases required stenting or balloon occlusion. However, readiness of access and intervention equipment enabled seamless escalation if needed and enhanced procedural confidence. Conclusion: We describe a stepwise operative algorithm integrating vascular preparation into robotic MALS surgery. The approach is reproducible, practical, and provides a critical safety net in high-risk anatomy. These procedural steps will be showcased to support broader adoption.