Single‐incision cholecystectomy in a patient with situs inversus totalis presenting with cholelithiasis: A case report

Abstract

Laparoscopic cholecystectomy has become the gold standard for the treatment of cholelithiasis, and many reports of single-incision laparoscopic cholecystectomy have been published in the past few years. Situs inversus totalis is a very rare condition, but the variant anatomy should not preclude a minimally invasive approach to surgery. We report a case of successful single-port laparoscopic cholecystectomy in a patient with situs inversus totalis, describe the technical advantages, and review the literature.

Single Port Laparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis: A Case Report

“…In response to the patients' demands for less pain and better cosmetic results, five cases of single port laparoscopic cholecystectomy in situs inversus totalis patients have been published currently. 4,[6][7][8] Laparoscopic cholecystectomy is the most conventional procedure applicable in all cases, but there is a disadvantage in the use with situs inversus totalis patients, as the operation is difficult for right -handed surgeons to handle instruments and mirror images. There are many ways to overcome these limitations, but there is no established method yet.…”

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

“…Recently 7 cases of single incision laparoscopic cholecystectomy in patients with SIT have been reported. 9,10 With this method the operators could perform dissection with their right hand more conveniently, without the necessity of crossing their hands at any point of time during the surgery.…”

Bile Duct Injury Following Laparoscopic Cholecystectomy In A Patient With Situs Inversus

“…[1] Diagnosis of gallstone disease in patients with situs inversus is difficult, especially in those with an unknown history of this condition. [2] Because of the eccentric anatomy of the left-sided gallbladder, the clinical presentation of these patients usually involves left upper-quadrant pain; however, 30% of patients reportedly develop epigastrium pain, including this patient. Approximately 10% of patients complain of right upper-quadrant pain, which is a classic presentation in patients without situs inversus.…”

“…Approximately 10% of patients complain of right upper-quadrant pain, which is a classic presentation in patients without situs inversus. [2] Clinical features and routine presurgical imaging including ultrasonography (US) could miss the anomalous position, there by producing complications during surgery. [3] Since the first published paper of left-sided position of the gallbladder in 1886, less than 150 cases have been reported in the literature.…”

“…[3] These articles tell us that, laparoscopic cholecystectomy in patients with a left-sided gallbladder is not often confidently performed by righthanded surgeons because of the unusual orientation. [1][2][3][4][5] However, none of these articles report any biliary injury after laparoscopic cholecystectomy. This may be due to surgeons giving more attention than usual in this kind of operation or perhaps they do not report bile duct injuries for these cases.…”