Figure 10.

Rectus sheath block and preperitoneal infiltration: laparoscopic and ultrasonographic views. (A) Laparoscopic images obtained during pneumoperitoneum show injection at the lateral end of the rectus abdominis muscle, with spread first within the deep rectus sheath (one yellow star) and then into the preperitoneal space after detachment of the parietal peritoneum (two yellow stars). (B) Postoperative ultrasound demonstrates the injected solution within the deep rectus sheath (one yellow star) and a lateral hypoechoic area consistent with preperitoneal dissection (two yellow stars), although after resolution of the pneumoperitoneum the peritoneum itself is no longer clearly distinguishable. (Reproduced from Marrone et al¹⁰ © Wolters Kluwer Health, Inc. Published with permission under STM Permissions Guidelines).