Sepehr Lalezari, MD, Hien T Nguyen, Gina L Adrales, Jean-Pierre Ouanes, MD, Michael A Schweitzer. Johns Hopkins
INTRODUCTION: Enhanced recovery pathways are an area of increasing interest for minimally invasive surgeons. The transversus abdominis plane (TAP) block has been adopted by many as a way to improve post-operative pain control. We present our modified version of the TAP block, the trans-peritoneal transversus abdominis plane (TP-TAP) block, which we utilized ultrasound to confirm proper delivery of anesthetic.
CASE PRESENTATION: Case presentation of a 26yo and a 41yo female undergoing vertical sleeve gastrectomy. A long 18gauge laparoscopic aspiration needle, commonly used for bile aspiration from a distended gallbladder, was utilized to deliver 30cc of 0.5% marcaine with 1/1:100000 epinephrine mixed with 30cc saline. A total of 60cc of this mixture was delivered bilaterally under laparoscopic guidance at the conclusion of the operation. Our injections are usually only done under laparoscopic guidance, but in this patient, we confirm with ultrasound that successful delivery of local anesthetic is in the proper position between the transversus abdominis muscle and internal oblique.
DISCUSSION: TP-TAP is a safe and effective modification to the traditional methods of performing a TAP block. It may be done by the operating surgeon and does not require the use of ultrasound.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87196
Program Number: V244
Presentation Session: Thursday Video Loop (Non CME)
Presentation Type: VideoLoop