I thought I would update here. I ended up having open surgery with Dr. Mallory Meyer in Denver on 3/22. The surgery went well. I haven't had any nausea or stabbing MALS pain since the surgery, although admittedly it's only been a few days. Most of my pain is right along the incision, and of course the horrible gas pain in my shoulder and sides that took until yesterday to calm down. Honestly the gas pain was worse than the incision pain. My biggest problem was the combo of anesthesia and oxycodone which shut my bladder and bowels down completely, so I had to quit oxycodone and get by with gabapentin, tylenol and a heating pad to get over that. Time will tell, but I think Dr. Meyer is someone worth considering for MALS surgery if you think the Dr. Hsu approach is best (she has studied his approach and is very interested in treating MALS). She believes that nerve involvement is a big part of the symptoms but also cuts back the MAL 4 cm and trims it. Apparently I had a huge mass of inflamed nerve tissue around my celiac artery, which she removed. Of course she is a young surgeon so it was a bit of a risk, but I wasn't willing to wait 4-6 months with my symptoms getting worse and worse.