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Median Arcuate Ligament Syndrome (MALS) Cutting Edge Robotic Surgery
Dr. Shouhed - Recognized across the country as one of the authoritative figures on the diagnosis and treatment of MALS. Schedule Your Consultation
Watch this video of Dr. Shouhed explaining MALS

Do You Have MALS?

Median arcuate ligament syndrome, or (MALS), is a rare, complex, under-diagnosed disease that often causes chronic, debilitating pain in the upper part of the abdomen. People with MALS are born with an anatomic abnormality of the their diaphragm and median arcuate ligament, causing the median arcuate ligament to compress the celiac artery, a major branch of the abdominal aorta, and the celiac nerve ganglion and plexus of nerves. This pressure can lead to blood flow changes, as well as nerve entrapment and inflammation, resulting in extreme pain, sitophobia (fear of eating), significant weight loss, constipation and diarrhea.

Once MALS is diagnosed, there are two main treatments that may be recommended. A celiac block injection can offer temporary relief and is commonly used as part of the diagnosis process, but it does not permanently relieve pressure on the celiac plexus nerves or aorta. MALS surgery offers a long-lasting solution to relieve the symptoms of MALS.

Minimally Invasive Robotic MALS Surgery

Myths About MALS Surgery. There's been myths that patients have shared with me whereDr. Shouhed is uniquely qualified to offer patients innovative robotic surgery as a treatment option for MALS. He has published multiple peer-reviewed articles on MALS and is recognized across the country as one of the authoritative figures on the diagnosis and treatment of MALS. He is not only an expert in the diagnosis and treatment of MALS, but with the superior skill provided by Dr. Shouhed, robot-assisted MAL release can be performed safely and effectively with the avoidance of conversion events and minimal morbidity.

The robotic approach will allow for a very precise and delicate dissection with release of the ligament,” says Dr. Shouhed. In this procedure, 5-6 tiny incisions are made in the abdomen to access the median arcuate ligament and view the tissues through a laparoscope. The ligament is separated and released to relieve compression on the celiac artery of the aorta and irritation of the nerves of the celiac plexus.

MALS surgery usually requires an overnight stay in the hospital for observation, but most patients can return home the next day. Symptoms like abdominal pain after eating are usually relieved immediately after MALS surgery.

If you have been diagnosed with MALS and want to explore permanent treatment options, contact our office in Los Angeles. Our staff can schedule a consultation with Dr. Shouhed to discuss MALS surgery, or median arcuate ligament release.

Danny Shouhed, MD, FACS

Dr. Danny Shouhed is an expert in foregut disease and disorders that involve the upper gastrointestinal (GI) tract. He is a nationally renowned mentor and educator, going across the country to train other attending surgeons and residents in MALS and robotic surgery. Patients suffering from MALS travel from around the globe to have consultations with Dr. Shouhed. With his extensive knowledge and specialized training, Dr. Shouhed is uniquely qualified to offer patients innovative robotic surgery as a treatment option for MALS. He has published multiple peer-reviewed articles on MALS and is recognized across the country as one of the authoritative figures on the diagnosis and treatment of MALS. He is not only an expert in the diagnosis and treatment of MALS, but with the superior skill provided by Dr. Shouhed, robot-assisted MAL release can be performed safely and effectively with the avoidance of conversion events and minimal morbidity. There are only select few surgeons in the country who can perform this type of surgery.

“It is important to be very strategic and calculated to make sure that the diagnosis is correct. The robotic approach can then allow for a very precise and delicate dissection with release of the ligament,” says Dr. Shouhed.

Dr. Shouhed graduated from UCSD School of Medicine and completed his general surgery residency at Cedars Sinai, where he developed his passion for minimally invasive surgery of the gastrointestinal tract. He then went on to complete fellowship training in metabolic (bariatric), endocrine and minimally invasive surgery at Mount Sinai Hospital. Dr. Shouhed was immediately recruited back to join the division of Minimally Invasive GI Surgery at Cedars Sinai Hospital. He is the associate director of the Minimally Invasive and Bariatric Surgery fellowship and was appointed to be the director of the Robotic Catalyst program. Dr. Shouhed has presented his work and been invited to speak at numerous national and international conferences and meetings. He has published over 50 peer-reviewed journal articles and chapters in the Journal of JAMA Surgery, JACS, Archives of Surgery and other reputable journals, including several articles specifically on MALS.

Top Los Angeles MALS Surgeon Dr. Daniel Shouhed Publishes Medical Journal Article Titled, "Clinico-Pathologic Findings in Patients with Median Arcuate Ligament Syndrome

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TRAVELING FOR MALS Surgery with Dr. Shouhed

At Dr. Shouhed's office, our entire team strives to make your personal experience as stress-free as possible. Our highly trained and dedicated staff are prepared with information for your travel options, accommodations and points of interest as well. Please call our office today for help with any of your travel arrangements:

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Beverly Hills Location

436 N Bedford Drive Suite 311
Beverly Hills, CA 90210

Phone: (310) 890-5834

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Santa Monica Location

2121 Santa Monica Blvd
Santa Monica, CA 90404

Phone: (310) 904-6647

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