Emergency Cholecystectomy in Situs Inversus Totalis: Report of a Case

Naikoo, GM; Wani, Imtiaz; Imran, Mudassar; Jan, Fozia; Mushtaq, Sobia; Ahmad, Mir Nazir

doi:10.4314/ijmu.v3i1.39859

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Although this is an anomaly in itself, it can very much lead to confusion, especially in those people who are confirmed cases of situs inversus. The widely accepted theory behind this confusion is said to arise due to the central nervous system not corresponding to the transposition of organs [9]. It is because of this very transposition that surgeons encounter difficulties while operating laparoscopically.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy in Situs Inversus Totalis Patients: A Case Report

ALakkad¹,

Almahameed²

2022

Preprint

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Laparoscopic surgery has been around in the general surgery world for a long time. It has revolutionized how conventional surgeries used to be carried out. Performing laparoscopic surgery , there is a faster recovery time, complications are less likely, and a significantly lower bleeding and hemorrhage-related risk in these patients. However, some surgeries are still carried out in the traditional ’open ’way. One major reason for this is the lack of skilled professionals available to carry out such complicated cases alone or the fact that some surgeries provide better access to the surgeons when carried out traditionally. This case study revolves around two patients, both of which presented with situs inversus. Situs inversus is a congenital condition where the majority or all of the organs present in the chest and abdomen mirror their normal physiological positions, that is, they are present in the opposite direction of where they normally should be. Since the condition revolves mainly around the ’position ’of the major body organs and does not usually involve any defect or malfunctioning in their ’ function’, it is usually seen that the affected people are capable of living on their own, without any complications affecting their lives. However, this was not the case with both of the patients that are being discussed in this case study. Both of them developed cholelithiasis. Their case was already bound to face complications owing to their condition-situs inversus. But, due to the presence of efficient and skilled surgeons working on the case, it was seen that laparoscopic cholecystectomy was performed on both of these patients. Whether this surgery was carried out successfully or led to further complications is the focus of this paper. Along with that, this study also aims to revolve to look at the diagnostic measures that led to effectively diagnosing the condition in these patients affected by situs inversus. Case Study

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy in Situs Inversus Totalis Patients: A Case Report

ALakkad¹,

Almahameed²

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The proposed explanation for this is that the central nervous system may not share in the general transposition. High degree suspicion is required in such cases [5] .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Cholecystectomy in Situs Inversus Totalis

2014

JCDR

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A 55-year-old gentleman known case of situs inversus totalis presented with dull aching type of pain in the upper abdomen more in the epigastrium and non radiating. It was associated with fullness of stomach and dyspepsia.On examination no jaundice or pyrexia was noted. Apex beat was on the right fifth intercostal space in the mid clavicular line. WBC counts and amylase levels were normal. USG abdomen [Table/ Fig-1] revealed left sided gallbladder with multiple calculi. There was no evidence of common bile duct or intrahepatic biliary radicals dilatation.Situs inversus totalis was confirmed with ECG [Table/ Fig-2] showing right axis deviation. Global negativity in lead I (a negative P-wave, QRS complex and T-wave). Positively deflected QRS complex in aVR. Negative P-wave in lead II. Reverse R-wave progression in precordial leads.The leads were placed in opposite direction and repeat ECG was obtained [ There were no comorbid conditions. Laparoscopic cholecystectomy was planned after obtaining a valid informed written consent. The operating set up and the monitor were placed in the direction opposite to conventional surgery. The operating team also changed their positions, primary surgeon and first assistant were standing on the right side and second assistant was standing on the left side.Under general anaesthesia on insertion of 10mm thirty degree storz system telescope camera all the contents were exactly found on the opposite side [Table/ Fig-7],10mm epigastric port was put and two 5mm ports were put in midaxillary and anterior axillary line on left side [Table /Fig-8]. The primary operating surgeon was right handed.He had to crossover his arms to retract the neck of the gallbladder with left hand and dissect the callot's with right hand. To prevent this difficulty the first assistant was asked to retract the neck of gallbladder [1] and the primary surgeon dissected out the callots triangle with right hand [1]. Surgery Section ABSTRACTSitus inversus totalis is a rare condition where the organs in the body is placed in the opposite side. When such patient presents with the diseases of the intra abdominal organs the diagnosis is challenging and the operative procedure to be performed will be difficult. This may require the anticipation of variations in anatomy, ergonomic changes required during surgery and mastery over the operative skills in reversed anatomy. Cholelithiasis in situs inversus totalis is one such situation. Herein we report a case of situs inversus totalis who underwent successful laparoscopic cholecystectomy for symptomatic gallbladder calculi.

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Emergency Cholecystectomy in Situs Inversus Totalis: Report of a Case

Cited by 2 publications

References 5 publications

Laparoscopic Cholecystectomy in Situs Inversus Totalis Patients: A Case Report

Laparoscopic Cholecystectomy in Situs Inversus Totalis Patients: A Case Report

Laparoscopic Cholecystectomy in Situs Inversus Totalis

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