Efficacy and Safety of a Surgeon Performed Laparoscopic Guided, 4-point Transversus Abdominis Plane Block: a retrospective review: A surgeon performed Transversus Abdominis Plane block, is a safe and efficacious intervention to improve post-operative pain thereby decreasing health care costs and narcotic consumption.

We performed a retrospective chart review from October 2017 to March 2019 to demonstrate the safety and efficacy of a surgeon performed, laparoscopically guided, transversus abdominis plane (TAP) blocks, for robotic-assisted gynecologic procedures. 116 patients who underwent robotic-assisted gynecologic surgery, at one academic hospital, with administration of a four-point TAP block were included. A four-point TAP block was performed under laparoscopic visualization, by the same surgeon, after induction of anesthesia and immediately following placement of the laparoscope. 20 mL of Liposomal bupivacaine and 20 mL of 0.5% bupivacaine mixed with saline were used as the injectate. All information from the surgical admission as well as postoperative follow up was reviewed. Data was presented in our descriptive study. 116 patients were included with a mean age of 40.6 (19-80) and a mean body mass index of 30.6 (17.2-53.3). 70.7 % of patients were discharged to home on the day of surgery. Of the 29.3% of patients who were admitted 20.6 % were due to pain control. Those who were admitted for pain control comprised 6.0% of the total of all study participants. There were no adverse events in our cohort and no readmissions due to pain control. A surgeon performed TAP block, under laparoscopic visualization, is a safe and efficacious intervention to reduce postoperative pain and may add to a multi-modal approach for enhanced recovery protocols.