Laparoscopic cholecystectomy in situs inversus totalis: Feasibility and review of literature

Abstract

Laparoscopic cholecystectomy is feasible and should be done in situs inversus totalis by experienced laparoscopic surgeon, as changes in anatomical disposition of organ not only influence the localization of symptoms and signs arising from a diseased organ but also imposes special demands on the diagnosis and surgical skills of the surgeon.

Laparoscopic Cholecystectomy for Acute Cholecystitis in Situs Inversus Totalis: An Extraordinary Approach

“…The surgeon who uses left hand has the advantage for adaptation during surgery (10). In our case, the surgeons were right-handed and the operation lasted 60 min.…”

Laparoscopic Cholecystectomy in Kartagener Syndrome

“…Technical modifications are required to perform this procedure successfully. Salama et al 9 recommended that contrary to the position of operative surgeon and the assistant surgeons in conventional laparoscopic cholecystectomy, the position may need to be reversed; however, in the index patient, as the gallbladder was on right side of falciform ligament in midabdomen, by putting operating port at Palmer's point in left hypochondrium and shifting other ports toward the right, we could perform the surgery by standing on left side of patient. Another technical difficulty experienced by the operating surgeon is the direction of cystic and common bile duct, which lies toward the right of gallbladder; because of mirror image anatomy of gallbladder, dissection of Calot's triangle with left hand through epigastric port becomes challenging.…”

The Rare Reason of Left Upper Quadrant Pain: Symptomatic Cholelitiasis in a Situs Inversus Totalis Case

“…Therefore, pain related to gall bladder pathologies in left upper quadrant could usually be in the left upper quadrant and epigastrium, moreover it could also be felt in the right upper quadrant where it normally takes place. [2] As the diagnosis of situs inversus totalis is usually made by coincidence, symptomatic cholelithiasis should always be remembered as a definitive diagnosis in patients with left hypocondrium and epigastrium pain. It is known that there is no increase in acute cholesystic incidence of patients with situs inversus totalis and extrahapetic biliary, venous and arterial anomalies of these patients are the same as normal population.…”