Technical difficulties and its remedies in laparoscopic cholecystectomy in situs inversus totalis: A rare case report

Arya, Satyavrat; Das, Anupam; Singh, Sunil Kumar; Kalwaniya, Dheer Singh; Sharma, Ashok; Thukral, Brij Bhushan

doi:10.1016/j.ijscr.2013.05.012

Cited by 36 publications

(48 citation statements)

References 4 publications

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“…If the assistant surgeon is made to retract the Hartmann's pouch through left midclavicular port, the right-handed surgeon can dissect the Calot's triangle with right hand through epigastric port. 10 In this patient, as the gallbladder was on the right side of porta hepatis, we did not have this problem. Use of special laparoscopic instruments like ultrasonically activated coagulating scissors for dissection can be beneficial in such cases as shown in previous reports.…”

Section: Discussionmentioning

confidence: 83%

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Laparoscopic Cholecystectomy in Kartagener Syndrome

Gupta¹,

Singh²,

Verma³

2017

Journal of Postgraduate Medicine, Education and Research

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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.

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Section: Discussionmentioning

confidence: 83%

“…A 45-year-old lady, a known case of Kartagener syndrome, presented with right hypochondriac pain jpmer CASe repOrT 10.5005/jp-journals-10028-1262…”

Section: Case Reportmentioning

confidence: 99%

Laparoscopic Cholecystectomy in Kartagener Syndrome

Gupta¹,

Singh²,

Verma³

2017

Journal of Postgraduate Medicine, Education and Research

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“…The laparoscopic access of the gall bladder, in case of a situs inversus, is difficult especially for the righthanded surgeons, and this may lead to lesions of the principal bile duct while dissecting the stone-block triangle especially that the anatomical alternatives of the bile ducts are more frequent in the event of a situs inversus. Several adaptations of the surgical technique were described [2,[5][6][7][8][9][10]. For our two patients, the symmetric of the usual disposition of the trocarts was carried out.…”

Section: Discussionmentioning

confidence: 99%

Acute Cholecystitis in Two Patients Carrying a Situs Inversus: A Diagnostic and Therapeutic Challenge

Haddad¹,

Sebai²,

Atri³

et al. 2017

J Clin Case Rep

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The situs inversus is a rare anatomical condition which is characterized by the transposition of organs towards the opposite side. The left position of the gall-bladder makes the diagnosis of acute cholecystitis difficult because of an unusual symptomatology. It is also associated with a difficulty of laparoscopic dissection of the stone-block triangle especially for the right-handed surgeons. We report the cases of 2 patients whose different explorations confirmed the diagnosis of acute cholecystitis and total situs inversus and benefited from a laparoscopic cholecystectomy. Laparoscopic cholecystectomy, in these two cases, is an original intervention because of the mirrored vision of the intraperitoneal organs and can even be difficult leading to iatrogenic complications. However, the laparoscopic approach remains the gold standard even in the presence of this mirrored anatomy.

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“…• Diagnosis is difficult and great attention is needed to exclude other diagnosis and know anatomical difficulties [8].…”

Section: Literature Reviewmentioning

confidence: 99%

“…This atypical mirror imaging not only needs great surgical skills but also meticulous preoperative planning. Surgeons must be aware of anatomical changes in a patient of symptomatic gall stone disease [8].…”

Section: Introductionmentioning

confidence: 99%

Situs Inversus: Open Cholecystectomy and Appendectomy: A literature Review

Din¹,

Shah²,

Ghazanfar³

et al. 2017

J Clin Case Rep

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Introduction: Situs inversus is a rare autosomal disorder with transposition of abdominal and thoracic organs. The prevelance is low upto 0.04%. Investigating the disease and performing surgical procedure is difficult because of difficult anatomy. We hereby report a case of symptomatic gallstones in 86 years old patient incidentally diagnosed as case of situs inversus after appropriate investigations. We also include a review of literature.

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Technical difficulties and its remedies in laparoscopic cholecystectomy in situs inversus totalis: A rare case report

Abstract: Therefore, it becomes important for the right handed surgeons to modify their techniques and establish a proper hand eye coordination to adapt to the mirror image anatomy of the Calot's triangle in a patient of situs inversus totalis.

Cited by 36 publications

References 4 publications

Laparoscopic Cholecystectomy in Kartagener Syndrome

Laparoscopic Cholecystectomy in Kartagener Syndrome

Acute Cholecystitis in Two Patients Carrying a Situs Inversus: A Diagnostic and Therapeutic Challenge

Situs Inversus: Open Cholecystectomy and Appendectomy: A literature Review

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