Simplified technique of laparoscopic cholecystectomy in a patient with situs inversus: a case report and review of techniques

Springer Science and Business Media LLC - Tập 15 - Trang 1-4 - 2015
Natthawut Phothong1, Thawatchai Akaraviputh2, Vitoon Chinswangwatanakul2, Atthaphorn Trakarnsanga2
1Department of Surgery, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
2Minimally Invasive Unit, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Tóm tắt

Situs inversus is a rare and silent autosomal recessive disorder occurring in 1:5,000 to 1:20,000 individuals. Laparoscopic cholecystectomy, a standard treatment for gallbladder disease in the general population, is very challenging in patients with situs inversus, especially for right-handed surgeons. We herein report a case involving our modified laparoscopic cholecystectomy technique for right-handed surgeons in a Thai patient with situs inversus who developed a symptomatic gallstone. We also include a short review of the literature. A 39-year-old female patient with dextrocardia presented with a 5-month history of episodic biliary colic. Abdominal ultrasonography revealed a left-sided gallbladder with gallstones. We performed laparoscopic cholecystectomy with our modified technique including port relocation. The operation went well, and our patient recovered satisfactorily. Laparoscopic cholecystectomy in patients with a left-sided gallbladder is not often confidently performed by right-handed surgeons. However, some modifications of “mirror image” ports focused on the more ergonomic port position are the keys to successful completion of this operation. The patient will thus still obtain benefits from this standard minimally invasive technique.

Tài liệu tham khảo

Iskandar ME, Radzio A, Krikhely M, Leitman IM. Laparoscopic cholecystectomy for a left-sided gallbladder. World J Gastroenterol. 2013;19:5925–8. Arya SV, Das A, Singh S, Kalwaniya DS, Sharma A, Thukral BB. Technical difficulties and its remedies in laparoscopic cholecystectomy in situs inversus totalis: A rare case report. Int J Surg Case Rep. 2013;4:727–30. Eisenberg D. Cholecystectomy in situs inversus totalis: a laparoscopic approach. Int Med Case Rep J. 2009;2:27–9. Patle NM, Tantia O, Sasmal PK, Khanna S, Sen B. Laparoscopic cholecystectomy in situs inversus-our experience of 6 cases. Indian J Surg. 2010;72:391–4. Lochman P, Hoffmann P, Koci J. Elective laparoscopic cholecystectomy in a 75-year-old woman with situs viscerum inversus totalis. Videosurgery Miniinv. 2012;7:216–9. Campos L, Sipes E. Laparoscopic cholecystectomy in a 39-year-old female with situs inversus. J Laparoendosc Surg. 1991;1:123–5. Fernandes MN, Neiva IN, de Assis CF, Meguins LC, Fernandes MN, Meguins EM. Three-port laparoscopic cholecystectomy in a brazilian Amazon woman with situs inversus totalis: surgical approach. Case Rep Gastroenterol. 2008;2:170–4. Ali MS, Attash SM: Laparoscopic cholecystectomy in a patient with situs inversus totalis: case report with review of literature. BMJ Case Rep 2013, 2013. Hall TC, Barandiaran J, Perry EP. Laparoscopic cholecystectomy in situs inversus totalis: is it safe? Ann R Coll Surg Engl. 2010;92:W30–2.