Laparoscopic Cholecystectomy in Kartagener Syndrome

Abstract

Kartagener syndrome is a rare autosomal recessive disorder in which there is situs inversus involving abdominal or thoracic viscera or both. Anatomy of the abdominal organs in such a patient is distorted making laparoscopic surgery very difficult. A 45-year-old lady, a known case of Kartagener syndrome, presented with epigastric pain. Ultrasound of abdomen revealed situs inversus with mild hepatomegaly and multiple gallbladder calculi. Magnetic resonance pancreatocholangiography (MRCP) confirmed situs inversus totalis with cholelithiasis and mild central intrahepatic biliary dilatation. Patient was treated successfully with laparoscopic cholecystectomy.

Two Surgeons' Technique for Laparoscopic Cholecystectomy in Situs Inversus for a Right-Handed Surgeon: Technical and Ergonomic Considerations

“…However, the problem with this technique is that it requires good coordination among the operating surgeons to prevent abnormal posture for the operating surgeon [15]. In this technique, the primary surgeon dissects the Calot's triangle with their dominant hand, while the infundibulum is retracted by the first assistant and the fundus by the second assistant [16][17][18]. The first assistant carries out posterior dissection while the operating surgeon retracts the infundibulum.…”