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2026, Number 1

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Acta Med 2026; 24 (1)

Robotic repair of a left intercostal hernia with transversus abdominis plane block under direct visualization: case report

Ruiz SR, Minutti PM, Yoshikai UK
Full text How to cite this article 10.35366/122160

DOI

DOI: 10.35366/122160
URL: https://dx.doi.org/10.35366/122160

Language: Spanish
References: 5
Page: 54-55
PDF size: 448.78 Kb.


Key words:

intercostal hernia, robotic surgery, TAP block, analgesia.

ABSTRACT

Robotic repair of abdominal intercostal hernias (HIA) presents an anesthetic challenge due to its location and high risk of postoperative pain. We present the case of a 59-year-old male diagnosed with HIA who underwent robotic repair under balanced general anesthesia. To optimize postoperative analgesia, a direct visualization transversus abdominis plane block (DV-TAP) was performed using 75 mg of 0.75% ropivacaine and 250 mg of 1% lidocaine with epinephrine. This case highlights the safety and efficacy of DV-TAP as an analgesic strategy in robotic surgery for HIA.


REFERENCES

  1. Bergholz D, Obi JR, Grossman R, Rasul TF. Robotic repair of an acquired abdominal intercostal hernia. CRSLS. 2021; 8 (4): e2021.00061.

  2. Prabhakar P, Ganapathi HP, Suresh V, Farias A, Manoharan M. Surgeon administered transversus abdominis plane block: anatomic principles and technique. J Robot Surg. 2023; 17 (4): 1193-1205.

  3. May PL, Wojcikiewicz T. Regional anaesthesia and fascial plane blocks for abdominal surgery: a narrative review. Dig Med Res. 2022; 5: 42. doi: 10.21037/dmr-21-83.

  4. Sertcakacilar G, Tire Y, Kelava M, Nair HK, Lawin-O'Brien ROC, Turan A et al. Regional anesthesia for thoracic surgery: a narrative review of indications and clinical considerations. J Thorac Dis. 2022; 14 (12): 5012-5028. doi: 10.21037/jtd-22-599.

  5. Doble JA, Winder JS, Witte SR, Pauli EM. Direct visualization transversus abdominis plane blocks offer superior pain control compared to ultrasound guided blocks following open posterior component separation hernia repairs. Hernia. 2018; 22 (4): 627-635. doi: 10.1007/s10029-018-1775-3.




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Acta Med. 2026;24