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Introduction Laparoscopic TAP block has been used in various surgical subspecialties to reduce postoperative opioid requirement and hence its side effects. The aim of our study was to evaluate the effect of laparoscopic TAP block in bariatric surgery. Methods We performed a retrospective analysis in patients who underwent bariatric surgery by two surgeons at a metropolitan public hospital from January 2019 to March 2020. One surgeon routinely performed laparoscopic TAP block (TAP group) with 80ml of 0.2% ropivacaine and the other surgeon performed port-site infiltration (non-TAP group) with either 0.2% or 0.75% bupivacaine. Patients with chronic pain were excluded. Baseline characteristics (age, gender, pre-op BMI, types of bariatric surgery), postoperative usage of opioids (in recovery, in the first 24 hours and opioid dosage) and length of stay (LOS) were collected and analysed. Results Seventy-nine patients were included in this study, of which 46 (58.2%) received laparoscopic TAP block and 33 (41.8%) received port site infiltration. Opioid requirement rates were lower in the TAP group: 54.3% (n = 25/46) received no opioids in recovery and 21.7% (n = 21/46) in the first 24 hours, compared to 48.5% (n = 16/33) in recovery and 9.1% (n = 3/33) in the first 24hours in the non-TAP group. However, there was no statistically significant difference (p = 0.61 and p = 0.13 respectively) between the two groups. Mean LOS was comparable in both groups. Conclusion Our study showed a non-statistically significant trend in reducing postoperative opioid usage with laparoscopic TAP block. Further evaluation with a prospective randomised controlled trial is warranted.

Introduction Length of stay (LOS) in laparoscopic sleeve gastrectomy (LSG) is affected by multiple factors, including gender, BMI >50, comorbidities, socioeconomic status and increased operative time (OT). This study aimed to evaluate the effect of reduced OT on LOS. Methods Analysis was conducted using a prospective database in patients who underwent LSG by a single surgeon at a single institution from January 2015 to December 2019. Patients receiving other operations (e.g. adhesiolysis, cholecystectomy, para-oesophageal hiatal hernia repair or ventral hernia repair) during LSG were excluded. All the patients were divided into two groups: OT ≤ 60 minutes and OT > 60 minutes. Patient demographics and outcome variables, including LOS, 30-day readmission, unexpected return to operating theatre, complications and mortality, were collected and analysed. Results A total of 1412 patients were included. In OT ≤ 60 minutes group (N = 804), the average LOS was 1.37 days and the average operative time was 51.31 minutes. In OT > 60 minutes group (N = 608), the average LOS was 1.66 days and the average operative time was 77.95 minutes. OT ≤ 60 minutes group showed a statistically significant decrease in LOS compared to OT > 60 minutes group (P-value Conclusion Our study demonstrated that reduced OT (≤60 minutes) in LSG was associated with reduced LOS but without increase in complication rates and mortality. This has implications for economic considerations for both hospitals and patients, especially in self-funded payer models.