Does a simple surgery to remove scalene anterior scar tissue can work ?

It's hard to say for sure, so much depends on the surgeon, your own body & if that is what is causing the most symptoms for you.

I know some long ago did have scar tissue removed - and did see improvement , but I think the scar tissue regrew eventually.
But I don't know how long it took to cause symptoms again.

I have TOS from FHP (forward head posture) so i have for sure some scar tissue cause of hypoxia that compress the subclavian vein and plexus brachial on the anterior scalene
When you know that new scar tissue are growing, you can improve result by drinking water and make some massage. So after the removing of scar tissue, we can control the developpement of new scar tissue.

I think that the body itself will create the scar matter. THere is truma during the surgery, bledding in the area that contributes to the adhisive gray/white scar matter. Dead tissue has no where to go but to attach to the nearest body part.

Many doc's tried the pack with dang forgot the name, used during back surgery. But, that did not have long term outcome proven I believe by FDA for long term. So it was very difficult to get for TOS surgeons to use. Oh Adcon-L....
Often operative there is a lidocain soak that is laid in the area and helps reduce post op pain....not prevent scarring.

As another post, there was the use of Gortex, type to wrap the nerves, but the scar matter can entwine the nerves covered in the gortex pulling on them out of position back to more symptoms.

A big one too....if you received TOS say as a painter, or pitcher and go back to the same thing that cause the injury, you were not cured, just helped and will reinjure, or contribute to the scarring by injuring and killing healthy tissue.

New nerves do not regenerate once they are injured, you can help in various ways, surgical or not.

If it is venous TOS then there is a bypass they can do and move from the entrapment as the vein comes out of the scalense.

Weight lifters that bulk up, can create a compression. Can have surgery and most likely will scar up....

We all want cure, but hope for pain free days and more ability to feel normal.
Just no pills for that, self help, and great support.