Laparoscopic sleeve gastrectomy in a patient withsitus inversus totalisand Kartagener syndrome: an unusual surgical conundrum

Abstract

Kartagener syndrome is a rare autosomal recessive condition. Approximately 25% of those with situs inversus totalis suffer the syndrome. With the rising overall number and indications for bariatric surgery, this condition will be increasingly recognised. We present a case of a 25-year-old woman with SIT and Kartagener syndrome who underwent a laparoscopic sleeve gastrectomy. As with all bariatric surgery, a multidisciplinary team approach was important in managing such a case. There were considerable cognitive challenges for the surgical team both preoperatively and during the procedure. The patient tolerated the operation well and was discharged 2 days after the surgery. At 12-months follow-up, the patient had achieved 125% excess weight loss. This case illustrates that an experienced surgeon can safely perform a laparoscopic sleeve gastrectomy on a patient with situs inversus totalis.

Laparoscopic sleeve gastrectomy in a patient with situs inversus totalis: A case report

“…Similar good postoperative results were reported in other case studies in which LSG was performed in patients with SIT. 7 , 10 , 12 , 13 , 16 However, some complications have been reported with other bariatric surgeries. Samaan et al.…”

“… 6 However, to our knowledge, only a few medical reports have described bariatric surgery in patients with SIT. 7 Herein, we report a successfully performed laparoscopic sleeve gastrectomy (LSG) in a morbidly obese patient with SIT.…”

Laparoscopic Sleeve Gastrectomy in a Patient With Situs Inversus Totalis and Kartagener Syndrome

“…All cases had SIT except one case that had SI partials [14] and another that had situs ambiguous [15]. Four cases had Kartagener syndrome [16][17][18]. One case had a planned additional procedure [19] and another had an unplanned additional procedure [15].…”

“…French position used nine times [16,19,20,[23][24][25][26][27]. The primary surgeon stood between the legs in eight cases [16,20,[23][24][25][26][27], to the left of the patient in six cases [14,15,17,21,28] and to the right in three cases [18,19,22]. The surgeon position was missing in two cases [29,30].…”

“…Most of the cases had obesity-related comorbidities. Five cases had prior surgeries [19,25,[27][28][29] with a single article that did not provide surgical history [17]. Only three cases had a perioperative complication [15,18,29].…”