Exparel Intra Operative Pain Injection

A new FDA-approved engineered technology applies "Tissu Glu," a surgical adhesive that strongly bonds the tissue layers of the abdomen together. The bond reduces space between the layers where fluid may collect and helps reduce the need for drains. Abdominal drains are uncomfortable and most patients and their caregivers have anxiety and concern about the care of the drains after the surgery. Studies have shown that patients who were treated with “Tissu Glu” were able to return to their normal activities sooner than those patients with abdominal drains.

At this point, we're going to inject a long-acting local anesthetic. It's called Exparel. Exparel is a very unique type of medication. This has been developed, basically, by micro-technology. And what this is, are small little molecules of a long-acting anesthetic called bupivacaine, that are wrapped with multiple layers of lipid, and as the lipid dissolves, the bupivacaine, which is the long-acting anesthetic, is then locally expressed and released into the tissue. What we're going to do, is inject that into the muscle, because in a tummy tuck, the major pain that's associated with a tummy tuck, is when we're sewing the separated muscles together. So this is going to help markedly reduce the pain. The unique thing about this, is that this released over about a three-day period of time, and that's the time when you have the most pain immediately after your tummy tuck.

I think it's interesting, because before this, what I would do is have what we would call a pain puff. A pain puff were little tubes that were inserted underneath the tissue and into the muscle, and the little tubes were then attached to a little pump that would then gradually pump this same bupivacaine into the tissue. But with this new technology, the injection, we don't need any drains, we don't need any tubes, and we don't need any bulb with a fanny pack, and all that sort of thing, that would have problems, that could get cold out, there were so many uncomfortable, and they had some other problems as well.