Nagata J, Watanabe J, Sawatsubashi Y, Akiyama M, Arase K, Minagawa N, Torigoe T, Hamada K, Nakayama Y, Hirata K. Novel technique of abdominal wall nerve block for laparoscopic colostomy: Rectus sheath block with transperitoneal approach. World J Gastrointest Surg 2017; 9(8): 182-185 [PMID: 28932352 DOI: 10.4240/wjgs.v9.i8.182]
Corresponding Author of This Article
Jun Nagata, MD, PhD, Department of Gastroenterological and General Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, 1-17-1 Hamamachi, Wakamatsu-ku, Kitakyushu, Fukuoka 808-0024, Japan. junsgy@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2017; 9(8): 182-185 Published online Aug 27, 2017. doi: 10.4240/wjgs.v9.i8.182
Novel technique of abdominal wall nerve block for laparoscopic colostomy: Rectus sheath block with transperitoneal approach
Jun Nagata, Jun Watanabe, Yusuke Sawatsubashi, Masaki Akiyama, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Kotaro Hamada, Yoshifumi Nakayama, Keiji Hirata
Jun Nagata, Yusuke Sawatsubashi, Masaki Akiyama, Yoshifumi Nakayama, Department of Gastroenterological and General Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka 808-0024, Japan
Jun Watanabe, Department of Surgery, Yokosuka Kyosai Hospital, Kanagawa 238-0011, Japan
Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Keiji Hirata, Department of Surgery, University of Occupational and Environmental Health, Fukuoka 808-0024, Japan
Kotaro Hamada, Department of Anesthesiology, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka 808-0024, Japan
Institutional review board statement: This case report was exempt from Institutional Review Board standards at University of Occupational and Environmental Health.
Informed consent statement: The patient involved in this manuscript gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflict of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jun Nagata, MD, PhD, Department of Gastroenterological and General Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, 1-17-1 Hamamachi, Wakamatsu-ku, Kitakyushu, Fukuoka 808-0024, Japan. junsgy@gmail.com
Telephone: +81-93-7610090 Fax: +81-93-5883904
Received: November 29, 2016 Peer-review started: November 29, 2016 First decision: February 20, 2017 Revised: March 20, 2017 Accepted: April 23, 2017 Article in press: April 24, 2017 Published online: August 27, 2017 Processing time: 268 Days and 16.3 Hours
Abstract
A 62-year-old man who had acute rectal obstruction due to a large rectal cancer is presented. He underwent emergency laparoscopic colostomy. We used the laparoscopic puncture needle to inject analgesia with the novel transperitoneal approach. In this procedure, both ultrasound and laparoscopic images assisted with the accurate injection of analgesic to the correct layer. The combination of laparoscopic visualization and ultrasound imaging ensured infiltration of analgesic into the correct layer without causing damage to the bowel. Twenty-four hours postoperatively, the patient’s pain intensity as assessed by the numeric rating scale was 0-1 during coughing, and a continuous intravenous analgesic was not needed. Colostomy is often necessary in colon obstruction. Epidural anesthesia for postoperative pain cannot be used in patients with a coagulation disorder. We report the use of a novel laparoscopic rectus sheath block for colostomy. There has been no literature described about the nerve block with transperitoneal approach. The laparoscopic rectus sheath block was performed safely and had enough analgesic efficacy for postoperative pain. This technique could be considered as an optional anesthetic regimen in acute situations.
Core tip: This report demonstrated that transperitoneal rectal sheath block can be performed safely in achieving analgesia in patients undergoing laparoscopic colostomy. This transperitoneal rectal sheath block technique has the potential to become an additional postoperative regimen for various forms of laparoscopic abdominal surgery.
