Study was not started due to COVID-19 pandemic.

This study evaluates laparoscopic-guided TAP block for reducing opioid use after minimally invasive foregut and bariatric surgeries, comparing Bupivacaine HCL with Exparel®. Secondary outcomes include pain scores, length of stay, and PONV medication use.

In this study the investigators aim to investigate the efficacy of laparoscopic-guided TAP block in reducing post-operative opioid use following minimally invasive foregut and bariatric surgeries. The investigators will also compare and report the analgesia produced by Bupivacaine HCL vs Exparel ®, a prolonged slow release Liposomal Bupivacaine formulation. Secondary outcomes assessed will be VAS pain scores, length of stay, and PONV dosage administered.

Inclusion Criteria:

• gastric bypass & sleeve gastrectomy, duodenal switch and minimally invasive elective anti-reflux foregut surgeries such as - hiatal hernia repair, fundoplication and Heller myotomy.

Exclusion Criteria:

• Subjects who are known to be
• Allergic to Bupivacaine
• Chronic opioid users Page 4
• Had/have neurological conditions
• Have a diagnosis of chronic pain syndrome which requires them to consume regular analgesics > 3-months
• American Society of Anesthesiologists (ASA) Class IV & V patients with severe systemic disease that is a constant threat to life.
• Patients with abdominal drain use
• Patients with significant cardiovascular, liver or renal disease
• Presence of contraindications for bariatric or foregut surgery.
• Patients presenting postoperative complications will be excluded from final analysis & final data set
• History of bariatric or foregut surgery
• Patients who are pregnant
• Patients who are under the age of 18