Modified laparoscopic cholecystectomy technique for treatment of situs inversus totalis: A case report

Abstract

Laparoscopic cholecystectomy is a broadly used technique for gallbladder treatment. However, situs inversus, a rare anomaly, is reportedly difficult to treat by conventional laparoscopic cholecystectomy. A 36-year-old woman with chronic cholecystitis and multiple gallstones was found to have dextrocardia on a chest X-ray. Magnetic resonance imaging demonstrated situs inversus, cholecystitis, and cholelithiasis. We successfully performed laparoscopic cholecystectomy using our modified technique, which mainly involved a left-handed operation and adjustment of the port positions. This case will be very instructive for right-handed surgeons in the management of cholelithiasis by laparoscopic cholecystectomy in patients with situs inversus.

Laparoscopic cholecystectomy in situs inversus totalis: Case report with review of techniques

“…Situs inversus totalis (SIT) is a rare autosomal recessive congenital anomaly, with a global prevalence of 0.01% [1,5]. It is characterized by the transposition of both thoracic and abdominal viscera resulting in perfect mirror image of their normal anatomical position [5].…”

“…Situs inversus (SI) is rare congenital disorder with a an autosomal recessive mode of inheritance [1]. The estimated incidence varies from 1 in 5000 to 20,000 live births [1].…”

“…Situs inversus (SI) is rare congenital disorder with a an autosomal recessive mode of inheritance [1]. The estimated incidence varies from 1 in 5000 to 20,000 live births [1]. Situs inversus refers to spectrum of transposition of the body viscera, which can be complete (totalis) where both the thoracic and abdominal organs are reversed resulting in mirror image of the normal anatomical structures, or it may be partial (partialis) where either thoracic or abdominal organs are reversed [2].…”

Duodenoscope combined with laparoscopy in treatment of biliary stones for a patient with situs inversus totalis

“…Similarly, 3-ports technology could also be suitable. [11] Another difficulty is that the associated anomalies with SIT of the coeliac trunk andliver are reported to be very common in individuals with situs inversus. [12] Vascular anomalies may cause unwilling hemorrhage and confusion and make the operation more challenging.…”

Laparoscopic Cholecystectomy in Two Patients with Situs Inversus Totalis: A Case Report

“…Ren JJ et al described that they used 4-port method with assisting traction, and the right-handed operator used his left hand as a main operating hand while his right hand was holding the gallbladder. 7 Iusco DR et al laid the patient in French position with the operator standing between the patient' s legs, and modified the placement of 3 ports -a camera port at the right upper quadrant, an infraumbilical port and a left flank port for the operator. The operator changed his working/dissecting hand as occasion demands.…”