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ARTICLE TYPE : CASE REPORT

Published on :   01 Jan 2026, Volume - 1
Journal Title :   WebLog Journal of Anesthesiology | WebLog J Anesthesiol
Source URL:   weblog iconhttps://weblogoa.com/articles/wjan.2026.a0104
Permanent Identifier (DOI) :  doi iconhttps://doi.org/10.5281/zenodo.18211587

Scarless Trans‑Umbilical Wedge Resection of a Prolapsed Vitellointestinal Duct Under Rectus Sheath Local Anesthesia Block in an Infant: A Case Report

Govani DR 1
Mehta AR 2
Midha PK 3
Govani ND 1
Panchasara NG 1
Patel RR 1
Patel RV 1 *
1Department of Pediatrics and Pediatric Surgery, Postgraduate Institute of Child Health & Research and KT Children Govt. University Teaching Hospital, Rajkot 360001, Gujarat, India
2Formerly Head, Dept of Surgery at Tata Memorial Hospital, Mumbai, India
3J. Watumull Global Hospital & Research Centre, Delwara Road, Mount Abu, Rajasthan 307501, India Affiliated to Medical Faculty of God Fatherly Spiritual University, Mount Abu, Rajasthan, India

Abstract

This manuscript describes a rare and clinically significant case of a prolapsed vitellointestinal duct (VID) in a 6‑week old‑old infant, successfully managed using a scarless trans‑umbilical wedge resection performed entirely under local anesthesia. While VID anomalies are well documented, the use of a minimally invasive, awake surgical approach in an infant is exceptionally uncommon. Our report highlights a safe and effective alternative to general anesthesia in selected infants, a cosmetically superior trans‑umbilical technique, a rapid postoperative recovery with same‑day discharge and practical, reproducible method that may benefit centers with limited access to pediatric anesthesia Trans‑umbilical natural orifice surgery (e.g., trans‑umbilical wedge resection, umbilical hernia repair, laparoscopic umbilical port entry) relies heavily on effective somatic analgesia of the periumbilical region. The rectus sheath block (RSB) is uniquely suited for this because it targets the anterior cutaneous branches of T9–T11, which supply the umbilical area.

Keywords: Patent Vitellointestinal Duct; Umbilical Anomalies; Prolapsed Vitellointestinal Duct; Natural Orifice Surgery; Trans-Umbilical Wedge Resection; Minimally Invasive Paediatric Surgery; Rectus Sheath Block; Neonatal Surgical Techniques; Scarless Surgery; Umbilical Reconstruction; Congenital Gastrointestinal Anomalies

Citation

Govani DR, Mehta AR, Midha PK, Govani ND, Panchasara NG, Patel RR, et al. Scarless Trans-Umbilical Wedge Resection of a Prolapsed Vitellointestinal Duct Under Rectus Sheath Local Anesthesia Block in an Infant: A Case Report. WebLog J Anesthesiol. wjan.2026.a0104. https://doi.org/10.5281/zenodo.18211587
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