If you live with median arcuate ligament syndrome (MALS), you’ve probably already learned that a band of tissue called the median arcuate ligament presses on the celiac artery. For decades, surgeons focused on that artery. But newer research finds that fibrotic tissue, or scar tissue, can surround and partially compress the celiac artery and nearby nerves. Examination of the removed tissue also revealed scarring around the nerves and an increase in small nerve fibers, supporting the theory that nerve compression is a contributing factor in the pain associated with MALS. For Californians weighing their MALS treatment options, celiac ganglion resection in Beverly Hills can treat the ligament and the nerve tissue in a single operation.

Read on to learn more about this procedure, whether you are a good candidate, and what to look for when searching for the best MALS surgeon in Los Angeles. 

How MALS Pain and Nerve Pain Are Connected

The celiac artery carries blood to the stomach, liver, and spleen. Wrapped around it sits the celiac plexus, a thick web of nerves and small nerve clusters called ganglia. These nerves carry pain signals from the upper abdomen to the brain. When the ligament sits too low, it crowds the artery and the nerves together. Over time, the area can become inflamed and scarred. Many experts now believe irritated nerves can explain the classic MALS pattern of upper abdominal pain after eating, nausea, and weight loss.

Can Median Arcuate Ligament Release Surgery Be Unsuccessful?

A standard median arcuate ligament release procedure cuts the ligament to free the artery. For some patients, that brings relief. For others, imaging shows improved blood flow after robotic MALS surgery, but the pain stays the same. One likely reason is that the scarred nerve tissue remains in place. The ligament is gone, yet the nerves that sat in that tight, inflamed space keep sending pain signals. Removing this tissue during the first operation may spare patients a second surgery later.

How Celiac Ganglion and Nerve Plexus Resection Works

Celiac ganglion and nerve plexus resection can be performed robotically through several small incisions. During this operation, a surgeon will:

  • Divide the ligament to free the celiac artery
  • Clear the scar tissue surrounding the artery
  • Remove celiac ganglion and nerve plexus tissue along with nearby lymph tissue
  • Confirm blood flow with ICG, a dye that glows under a special camera, and with ultrasound

For people looking for a surgeon who provides the best nerve plexus resection in Beverly Hills, the robotic approach matters because the nerves sit right next to the aorta, the body's largest artery. A magnified 3D view and precise, wristed instruments let the surgeon remove the tissue carefully and precisely. With this approach, most patients go home the day after surgery.

Who Can Benefit From Celiac Ganglion and Nerve Plexus Resection?

Patients who see the most improvement from celiac ganglion and nerve plexus resection usually share a few traits:

  • Pain in the upper middle abdomen that starts soon after eating
  • Clear relief after a celiac plexus block, a numbing injection near these nerves
  • Ongoing pain after a prior ligament release
  • Testing that has ruled out gallbladder disease, ulcers, and slow stomach emptying

Traveling for MALS Surgery

You do not need to live in Los Angeles to get the superior MALS treatment. Patients from the Bay Area, San Diego, Sacramento, Fresno, and the Inland Empire can begin with a virtual consultation and send their imaging and records for review before they travel. Most patients spend one night in the hospital. Many feel better within weeks, though the full benefit can take six to 12 months as the nerves heal and eating becomes easier. Additionally, follow-up visits can happen by video once you are home.

Looking for a Surgeon Who Provides Celiac Ganglion Resection in Beverly Hills?

Dr. Danny Shouhed is considered one of the leading experts in MALS and MALS treatments. Among his many accomplishments, he co-edited a 2025 medical textbook from Springer devoted to MALS, alongside Dr. Omar Ghanem and Dr. Kevin El-Hayek. He also co-authored the 2021 pathology study documenting nerve scarring in MALS patients and serves on the board of the MALS Foundation. As Cedars-Sinai's highest-volume robotic surgeon, he brings that robotic skill to every MALS operation.

Dr. Shouhed combines ligament release, celiac ganglionectomy, and lymphadenectomy into one robotic procedure and confirms blood flow with ICG imaging and ultrasound before finishing. This approach gives Californians the option for a single surgery that addresses both the artery and the nerves.

If you’re considering celiac ganglion resection in Beverly Hills, we’re ready to set up a virtual consultation and build a plan that fits your needs.