A laparoscopic TAP block takes a few minutes at the end of the case. With the camera inside, the needle can be seen tenting the peritoneum and the local anaesthetic lifting it as a bulge between the internal oblique and transversus abdominis. Doing it under vision avoids the need for ultrasound and a separate anaesthetic procedure.
- Calculate the total local anaesthetic dose before starting, including port-site infiltration.
- Look for the Doyle's bulge — a peritoneal bulge lateral to the semilunar line.
- Inject bilaterally at subcostal and lateral positions for a dual block.
- Aspirate before each injection.
Why it matters
A surgeon-placed block costs minutes and needs no extra equipment.
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