Laparoscopic Cholecystectomy in Situs Inversus Totalis

Takei, Hiroyuki; Maxwell, J. Gary; Clancy, Thomas V.; Tinsley, E. A.

doi:10.1089/lps.1992.2.171

Cited by 63 publications

(52 citation statements)

References 10 publications

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“…[1][2][3][4] The cause of the transposition is unknown, but it is claimed to be due to a genetic predisposition, with an autosomal recessive transmission. Associated anomalies are known to be quite frequent.…”

Section: Discussionmentioning

confidence: 99%

“…Since first performed by Mouret in France in 1987, laparoscopic cholecystectomy has rapidly evolved as the standard therapeutic modality for gallstone disease, after it was refined and popularized in the United States by Reddick and Olsen. 1 Drover et al reported the first case to have laparoscopic cholecystectomy with this type of anomaly. 5 Although the intrahepatic and extrahepatic biliary anatomy are mirror images of normal, there is a higher likelihood of associated anomalies, which might add an additional challenge to performing a laparoscopic procedure.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Cholecystectomy in Situs Viscerum Inversus Totalis

1998

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy in Situs Viscerum Inversus Totalis

1998

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“…4,[6][7][8][9][10][11][12] In two different cases reported, 5,6 the pain was recurrent and located in the left upper quadrant of the abdomen. Others have reported that the pain of biliary colic in patients with situs inversus may occur in the epigastrium or the right or left upper quadrant.…”

Section: Discussionmentioning

confidence: 99%

“…This was mainly due to the abnormal spatial relationship of the gallbladder, cystic duct and cystic artery. However, since it is the mirror image of what is done with the gallbladder in the normal location, 6 once the surgeon is able to re-orient himself, the technical difficulty is easily overcome.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy in Situs Inversus Totalis: A Case Report and a Review of Literature

Malatani

1996

Ann Saudi Med

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TS Malatani, Laparoscopic Cholecystectomy in Situs InversusRecently, a case of cholelithiasis in situs inversus totalis was treated successfully by laparoscopic cholecystectomy. To the best of our knowledge, this is the first case reported in the literature of an Arab nation. Case ReportA 25-year-old Sudanese female was seen, complaining of recurrent epigastric and left-sided upper quadrant abdominal pain of two years duration. The pain was precipitated by fatty meals and was not associated with a history of jaundice or pancreatitis. A chest x-ray showed dextrocardia (Figure 1). Ultrasonography of the abdomen disclosed a single stone in a left-sided gallbladder and a nondilated common bile duct (Figure 2). Liver function tests were within normal limits. A full upper gastrointestinal investigation did not reveal any other abnormalities.At surgery, under general anesthesia, a 10-mm trocar was placed in both the supraumbilical and subxiphoid locations, and a 5-mm trocar was placed in the left subcostal and left iliac fossa. The video screen was situated above the patient's left shoulder. The orientation of the gallbladder made it easier to operate from the undersurface of Calot's triangle after pulling Hartmann's pouch anteriorly and slightly to the right in order to skeletonize the cystic duct and cystic artery using instruments with a right-angled tip. It was not easy, but it was still possible to complete the cholecystectomy laparoscopically. The procedure lasted 70 minutes. The patient was discharged the next day and was well when seen for follow-up six months later. Pathological examination of the gallbladder wall showed chronic inflammation. Figure 1. Chest x-ray shows dextrocardia.

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“…• Situs inversus totalis does not appear to be a contraindication [1,4] to laparoscopic cholecystectomy even in case of empyema [3].…”

Section: Recommendations and Future Scopementioning

confidence: 99%

Laparoscopic Cholecystectomy in Situs Inversus Totalis

2014

JCDR

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A 55-year-old gentleman known case of situs inversus totalis presented with dull aching type of pain in the upper abdomen more in the epigastrium and non radiating. It was associated with fullness of stomach and dyspepsia.On examination no jaundice or pyrexia was noted. Apex beat was on the right fifth intercostal space in the mid clavicular line. WBC counts and amylase levels were normal. USG abdomen [Table/ Fig-1] revealed left sided gallbladder with multiple calculi. There was no evidence of common bile duct or intrahepatic biliary radicals dilatation.Situs inversus totalis was confirmed with ECG [Table/ Fig-2] showing right axis deviation. Global negativity in lead I (a negative P-wave, QRS complex and T-wave). Positively deflected QRS complex in aVR. Negative P-wave in lead II. Reverse R-wave progression in precordial leads.The leads were placed in opposite direction and repeat ECG was obtained [ There were no comorbid conditions. Laparoscopic cholecystectomy was planned after obtaining a valid informed written consent. The operating set up and the monitor were placed in the direction opposite to conventional surgery. The operating team also changed their positions, primary surgeon and first assistant were standing on the right side and second assistant was standing on the left side.Under general anaesthesia on insertion of 10mm thirty degree storz system telescope camera all the contents were exactly found on the opposite side [Table/ Fig-7],10mm epigastric port was put and two 5mm ports were put in midaxillary and anterior axillary line on left side [Table /Fig-8]. The primary operating surgeon was right handed.He had to crossover his arms to retract the neck of the gallbladder with left hand and dissect the callot's with right hand. To prevent this difficulty the first assistant was asked to retract the neck of gallbladder [1] and the primary surgeon dissected out the callots triangle with right hand [1]. Surgery Section ABSTRACTSitus inversus totalis is a rare condition where the organs in the body is placed in the opposite side. When such patient presents with the diseases of the intra abdominal organs the diagnosis is challenging and the operative procedure to be performed will be difficult. This may require the anticipation of variations in anatomy, ergonomic changes required during surgery and mastery over the operative skills in reversed anatomy. Cholelithiasis in situs inversus totalis is one such situation. Herein we report a case of situs inversus totalis who underwent successful laparoscopic cholecystectomy for symptomatic gallbladder calculi.

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Laparoscopic Cholecystectomy in Situs Inversus Totalis

Cited by 63 publications

References 10 publications

Laparoscopic Cholecystectomy in Situs Viscerum Inversus Totalis

Laparoscopic Cholecystectomy in Situs Viscerum Inversus Totalis

Laparoscopic Cholecystectomy in Situs Inversus Totalis: A Case Report and a Review of Literature

Laparoscopic Cholecystectomy in Situs Inversus Totalis

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