Derivação gastrojejunal com anel de contenção no tratamento de obesidade mórbida em paciente com situs inversus totalis

Abstract

The gastric bypass is a good option in the therapy of morbid obesity. Nevertheless, it must be considered the rare condition as occurred in a patient with previous abdominal surgery with Situs Inversus Totalis. A 24 year-old male patient with body mass index of 40 Kg/ m(2), multiple dietary failures, and arterial hypertension as co-morbidities, with a anterior paramedial right incision due to a previous appendicectomy (8 years ago).With a indication for bariatric surgery, was performed Roux-en-Y gastric bypass by laparoscopic procedure, with previous planning of Situs Inversus Totalis.

Evidences on the clinical and anatomical aspects of situs inversus

“…DSI is rare, accounting for 0.2% of all congenital heart defects (Romero et al, 2017). However, it can cause difficulties in the treatment of abdominal diseases, especially in laparoscopic procedures, due to its mirror image (Barros et al, 2010). Most reports of laparoscopic surgery in patients with SIT have involved cholecystomy.…”

Laparoscopic Roux-en-Y gastric bypass in a patient with situs inversus totalis: Case report, technical tips and review of the literature

“…In one case the authors did not provide any demographic data about their patient [ 20 ]. Laparoscopic Roux-en-Y gastric bypass (LRYGB) was performed in 5 patients (22.7%) [ [1] , [4] , [12] , [13] , [14] ]; Laparoscopic banded Roux-en-Y gastric bypass (LBRYGB) in one patient [ 9 ]; Robotic assisted RYGB (RRYGB) in one patient [ 11 ]; and laparoscopic adjustable gastric banding (LAGB) in 5 patients [ [2] , [5] , [6] , [7] , [8] ]. Laparoscopic sleeve gastrectomy (LSG) was performed in 7 patients [ [3] , [10] , [12] , [15] , [16] , [19] , [21] ]; modified duodenal switch (LSG + duodeno-jejunal bypass, and stomach-intestine pylorus sparing; SIPS) in two cases [ [17] , [18] ], and there was a single case of Omega loop gastric bypass or mini gastric bypass that was published with a Supplementary video [ 20 ].…”

“…A total of five patients underwent LRYGB [ [1] , [4] , [12] , [13] , [14] ], one had a banded RYGB [ 9 ], another patient had a robotic assisted surgery[ 11 ], and one patient had an Omega loop or mini gastric bypass [ 20 ]. A total of seven patients had LSG [ [3] , [10] , [12] , [15] , [16] , [19] , [21] ], one patient had a LSG with duodeno-jejunal bypass [ 17 ] and another patient had SIPS [ 18 ].…”