• Antonio Pellegrino, Gianluca Raffaello Damiani, Daniele Speciale, Roberto Speciale, Riccardo Massei, Stefano Landi, and Mario Villa.
• Department of Obstetrics and Gynecology, Alessandro Manzoni Hospital, Lecco, Italy.
• J Minim Invasive Gynecol. 2013 Mar 1;20(2):230-3.

AbstractThe laparotenser instrument is used to perform isobaric laparoscopy to avoid adverse effects in the pneumoperitoneum. To decrease hospitalization time and increase the rate of same-day discharge, we investigated the safety of isobaric laparoscopy using the Laparotenser, a new subcutaneous abdominal wall-lifting system, with transversus abdominis plane (TAP) block combined with locoregional anesthesia (subarachnoid, peridural, spino-peridural) for patients undergoing minor and major gynecologic surgeries. With this combination of anesthetics, TAP block enabled us to anesthetize the supraumbilical region while the pelvic region was covered by locoregional anesthesia. We describe our experience with TAP blockade associated with locoregional anesthesia during gasless laparoscopy. We performed ultrasound-guided TAP block with ropivacaine 0.25% 20 mL to cover the supraumbilical region in association with locoregional anesthesia (lumbar subarachnoid-peridural-spinoperidural) and bupivacaine 0.5% (10 mg/3 mL) to cover the lower pelvic region. Successful outcome was reported in 81.3% (13/16) of the patients.Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

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