Role of minimally invasive techniques in gastrointestinal surgery: Current status and future perspectives.
Shan-Ping Ye, Wei-Quan Zhu, Zhi-Xiang Huang...
https://pubmed.ncbi.nlm.nih.gov/34621471/Actively Recruiting
Led by Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute) · Updated on 2025-09-18
48
Participants Needed
1
Research Sites
26 weeks
Total Duration
Researchers are evaluating the effectiveness of three different routine pain management methods used during minimally invasive cancer surgery. This study compares Laparoscopic Transversus Abdominis Plane block LapTAP combined with Local Anesthetic LA, LapTAP alone, and LA alone. The trial aims to improve postoperative pain control in patients undergoing various types of minimally invasive oncologic surgeries by assessing these methods in a prospective, randomized control trial. Participants will be randomly assigned to one of three groups receiving LapTAP with LA, LapTAP alone, or LA alone during their surgery. The LapTAP procedure involves injecting ropivacaine into the fascial plane between abdominal muscles, while LA is administered around surgical port sites. All patients will receive standard pre- and post-operative care according to clinical guidelines, with the study treatments given during the surgery. During the study, researchers will collect data from medical records for 24 hours post-surgery and until hospital discharge, typically about one week. They will monitor pain scores hourly for 24 hours and at discharge, opioid consumption, recovery analgesic time, side effects, and patient satisfaction with pain management. Participation ends at hospital discharge, with no additional long-term follow-up beyond this period.
CONDITIONS
Optimal Perioperative Pain Control in Minimally Invasive Abdominal Cancer Surgery
C
Casey Allen, MD
A
AHN Clinical Trials Contact
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Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute)
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | LapTAP Block plus Local Anesthetic at Port Sites | LapTAP Block Only | Local Anesthetic Wound Infiltration Only |
|---|---|---|---|
| What it is | A combined approach in which a laparoscopic transversus abdominis plane (LapTAP) block is performed in addition to local anesthetic infiltration at all port sites after minimally invasive oncologic abdominal surgery. | LapTAP block is performed without additional local anesthetic wound infiltration at port sites after surgery. | Local anesthetic is injected around surgical port sites at the end of surgery without a LapTAP block. |
| Role in the trial | Evaluates whether combining LapTAP block and local anesthetic improves pain control compared to either technique alone. | Assesses pain control and recovery using LapTAP block as a standalone technique. | Serves as an established pain management reference using port-site local anesthetic only. |
| Primary use | To provide post-operative pain relief following minimally invasive oncologic abdominal surgery. | To reduce post-operative pain using LapTAP block after minimally invasive surgical procedures. | To manage pain after surgery by local anesthetic infiltration at port sites. |
| How it is given or performed | A LapTAP block is performed with ropivacaine (15 mL per side, 0.1%) injected into the fascial plane between the internal oblique and transversus abdominis muscles, plus additional ropivacaine administered at all port sites. | A surgeon injects ropivacaine into the transversus abdominis plane bilaterally (total 30 mL of 0.1%). No additional local anesthetic is given to port sites. | Ropivacaine (30 mL of 0.1%) is injected around the umbilical port site and 5 mL at each additional port site after surgery, without any LapTAP block. |
| Evidence status | The combination is being studied to determine whether dual analgesic methods improve pain scores and opioid use versus either technique alone. While both components are established, high-quality comparative studies for the combined method in this population are limited. | LapTAP block reduces pain and opioid use after minimally invasive abdominal surgery compared to no block or placebo. Evidence from meta-analyses and randomized trials supports its benefit over no block and similar performance to wound infiltration in some procedures. | Local anesthetic infiltration is effective for controlling pain at port sites and has been compared to LapTAP block in randomized trials with mixed findings on which technique offers better pain relief. |
| Important limitations | It is unknown whether combining LapTAP block with local infiltration offers added benefit, since combination use has not been as extensively studied as either technique alone; risks and resource use may be greater. | Effectiveness can vary by surgical procedure and patient. Some studies show LapTAP is not always superior to local infiltration and technical aspects may influence outcomes. | Effectiveness may be limited to pain at the surgical port sites, with less effect on overall abdominal or visceral pain. Some studies found LapTAP block offers broader pain control. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Surgery duration plus up to 1 week post-surgery
Participants undergo minimally invasive oncologic surgery and receive one of three pain management interventions: Laparoscopic Transversus Abdominis Plane block with Local Anesthetic, LapTAP alone, or Local Anesthetic alone.
1 surgery visit and daily assessments up to hospital discharge (on average 1 week)
Duration - Up to 1 week post-surgery
Participants are monitored for pain control effectiveness, opioid consumption, adverse events, and patient satisfaction until hospital discharge, approximately 1 week after surgery.
Daily assessments during hospital stay until discharge
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
3
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https://pubmed.ncbi.nlm.nih.gov/21296242/Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute)
Lead Sponsor