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Case Report: Single-port laparoscopic total gastrectomy for gastric cancer in patient with situs inversus totalis.

ABSTRACT: Situs inversus totalis (SIT) is a rare anatomical condition, where all the viscera appear in its reverse position. Although minimally invasive surgery has evolved to achieve totally laparoscopic gastrectomy for gastric cancer patients with SIT, it is difficult to perform lymphadenectomy in such a transposed anatomical condition. Recently, we performed a single-port laparoscopic total gastrectomy (SPTG) for gastric cancer in a patient with SIT. No postoperative complications or dietary problems were observed. Based on this experience, we are to design a safe strategy to perform D2 lymphadenectomy during SPTG in patients with SIT.

SUBMITTER: Lee IY

PROVIDER: S-EPMC9889819 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Case Report: Single-port laparoscopic total gastrectomy for gastric cancer in patient with situs inversus totalis.

Lee In Young IY Lee Danbi D Lee Chang Min CM

Frontiers in oncology 20230118

Situs inversus totalis (SIT) is a rare anatomical condition, where all the viscera appear in its reverse position. Although minimally invasive surgery has evolved to achieve totally laparoscopic gastrectomy for gastric cancer patients with SIT, it is difficult to perform lymphadenectomy in such a transposed anatomical condition. Recently, we performed a single-port laparoscopic total gastrectomy (SPTG) for gastric cancer in a patient with SIT. No postoperative complications or dietary problems w ...[more]

PMID: 36741026

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Case report: Laparoscopic-assisted distal gastrectomy for gastric cancer in a patient with situs inversus totalis.

Project description:BackgroundSitus inversus totalis (SIT) is a rare congenital disease with a series of clinical features characterized by a mirror image distribution of the viscera to the normal anatomy.Case presentationThis study aims to report a 63-year-old male SIT patient with gastric cancer with a preoperative diagnosis of stage IIB gastric cancer (cT3N0M0), who underwent a preoperative multi-disciplinary treatment (MDT) discussion and an abdominal enhancement CT for visceral evaluation to ensure a successful operation. A laparoscopic-assisted distal gastrectomy including D2 lymph node dissection and Billroth I reconstruction was successfully performed. Laparoscopic radical gastric gastrectomy and D2 lymph node dissection were performed through the opposite surgical station to the conventional one, followed by digestive tract reconstruction under small incision-assisted direct vision. There was less blood loss throughout the operation, no postoperative complications, and the patient was discharged successfully 10 days after surgery. Histopathological examination showed ulcerated high-medium differentiated adenocarcinoma stage IB (PT2N0M0). There were no complications or tumor recurrence in the patient with examination 6 months after the operation.ConclusionSurgery in a patient with gastric cancer and SIT can be safely performed by the application of 3D laparoscopy and small incisions to assist the digestive tract reconstruction under direct vision.

| S-EPMC10070824 | biostudies-literature

Laparoscopic sleeve gastrectomy in a patient with Situs Inversus Totalis: A case report and literature review

Project description:Introduction & Importance: Laparoscopic sleeve gastrectomy (LSG) is a widely accepted and effective bariatric surgery for achieving weight loss in patients with extreme obesity. Performing this surgical procedure in patients with congenital anatomical changes including situs inversus (SI) is a challenge for the surgical team. In this condition, the orientation of intra-abdominal organs is the mirror image of those in normal populations. Case presentation Herein, we present a 29-year-old female with situs inversus totalis who successfully underwent an LSG surgery with proper weight loss post-operatively and no early and late complications. Clinical discussion By reviewing the literature for patients with SI undergoing the same procedure, all patients achieved significant weight loss. Three out of nineteen cases experienced complications which were controlled without significant morbidity or mortality. Conclusion: we concluded that LSG will be a safe and effective surgery for the treatment of extreme obesity in SI patients, if the condition is diagnosed preoperatively. Highlights • Performing laparoscopic sleeve gastrectomy (LSG) in patients with situs inversus (SI) is a challenge for the surgical team.• SI should be diagnosed prior to surgery to avoid prolonged surgery and lack of expertise.• LSG will be a safe and effective surgery for the treatment of extreme obesity in SI patients.

| S-EPMC9289484 | biostudies-literature

Case Report: Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy for gastric cancer in a patient with situs inversus totalis: with video

Project description:Because of its significant advantage of fast postoperative recovery, natural orifice specimen extraction surgery (NOSES) has attracted increasing attention worldwide. However, the NOSES in gastric cancer (GC) treatment still needs more clinical practice, especially for the rare anatomical anomaly. Situs inversus totalis (SIT) is a rare autosomal recessive anatomical anomaly with an incidence ranging between 1/8,000 and 1/25,000 births. We present a video of transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy performed in a 59-year-old woman known to have SIT. Preoperative investigations revealed that the patient had early GC at the antrum. A gastroscopy report from the local hospital showed signet-ring cell carcinoma. The preoperative computed tomography scan revealed irregular thickening of the gastric wall at the junction of the greater curvature and antrum without metastasis to the lymph nodes. In total, laparoscopic D2 distal gastrectomy was performed with transvaginal specimen extraction. Billroth II with Braun anastomosis was performed for reconstruction. The length of the operation was 240 min without intraoperative complications and with minimal blood loss of 50 ml. The patient was uneventfully discharged on postoperative Day 7. The final pathology confirmed signet-ring cell carcinoma confined to the mucosal muscle without metastasis in 16 lymph nodes. Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy can be safely performed in patients with SIT and has similar surgical outcomes to usual laparoscopic gastrectomy.

| S-EPMC10242047 | biostudies-literature

Laparoscopic biliopancreatic diversion for a morbidly obese patient with situs inversus totalis: Case report.

Project description:INTRODUCTION:Situs inversus is a rare congenital anomlay in which the thoracic and abdominal organs are sited on the opposite side to that of normal anatomy. Its etiology is still unknown. It is classified into situs inversus partialis and situs inversus totalis. It is discovered incidentally in most cases. Any surgical intervention for such patients may encounter intra-operative technical difficulties due to anatomical differences, particularly if a laparoscopic approach is adopted, as in bariatric surgeries where the obesity itself opposes an added surgical challenge. CASE PRESENTATION:A female patient with a BMI of 52.1 Kg/m2 was being prepared for biliopancreatic diversion. She was diagnosed incidentally as having situs inversus totalis during the preoperative evaluation. She underwent an uneventful laparoscopic biliopancreatic diversion. She was followed up regularly in the bariatric surgery clinic for 9 years. Her last BMI was 29 Kg /m2 with no signs or symptoms of metabolic complications. CONCLUSION:This case report demonstrates that biliopancreatic diversion can be done safely in morbidly obese patients with situs inversus by an experienced bariatric surgeon in a specialized well-equipped center.

| S-EPMC6047057 | biostudies-literature

Reduced-Port Laparoscopic Surgery for Patients With Proximal Transverse Colon Cancer With Situs Inversus Totalis: A Case Report.

Project description:Situs inversus is a rare hereditary disorder in which various anomalies have been reported with internal rotation abnormalities. This case involved an 85-year-old woman who had been diagnosed with transverse colon cancer and who underwent reduced-port laparoscopic surgery. All intra-abdominal organs were reversed left to right and right to left. The aberrant midcolic artery was identified during surgery. The total surgery time was 170 minutes, and the patient lost 20 mL of blood. The patient was discharged on the 8th postoperative day without complications.

| S-EPMC6347341 | biostudies-literature

Laparoscopic Cholecystectomy in a Patient With Situs Inversus Totalis Presenting With Cholelithiasis: A Case Report.

Project description:Laparoscopic cholecystectomy is the standard treatment for cholelithiasis. A very rare condition named situs inversus should not be considered as a contraindication for laparoscopic cholecystectomy. Here, we reported a case of successful laparoscopic cholecystectomy in a patient with situs inversus totalis. We also described the technical advantages of this treatment and reviewed the literature.

| S-EPMC9046872 | biostudies-literature

Laparoscopic Roux-en-Y gastric bypass in a patient with situs inversus totalis: Case report, technical tips and review of the literature.

Project description:IntroductionLaparoscopic Roux-en-Y gastric bypass (LRYGB) has proven over the years to be one of the most effective bariatric procedures. It is highly technical, and therefore is mostly performed by bariatric and metabolic surgeons. Although Situs Inversus Totalis (SIT) is a very rare congenital condition, surgeons do occasionally have to operate intra-abdominally on those patients, consequently facing some challenges related to the unusual anatomy.Case presentationWe describe a rare case of LRYGB for chronic morbid obesity on a 43 year old patient with pre-operative diagnosis of situs inversus totalis without Kartagener's syndrome, using slight modification from the usual technique based on anatomical correlation without the need to change the surgeon's position or switching trocar placements as described in previous papers. This could help surgeons in general reduce the potential challenges faced when performing such procedure.ConclusionSitus Inversus Totalis is a rare congenital condition, but surgeons in general do encounter those patients throughout their career. This rare condition should not solely be an indication for an open approach as minimally invasive surgery, whether laparoscopic or robotic, is safe and should still be considered the standard of care approach. Bariatric surgery is one of the most technical intra-abdominal procedures mainly due to the patients' body habitus, different instrumentations used, and the different anastomoses created. Gastric bypass and bariatric surgery in general can be safely performed on patients with SIT without the need for major adjustment to the surgeon's position, trocar placement or instruments used.

| S-EPMC6000729 | biostudies-literature

Biliary stone in patient with situs inversus totalis.

Project description:Introduction and significanceSitus inversus totalis is characterized by the complete transposition of thoracic and abdominal viscera. Individuals can live asymptomatically with this condition; however, it may be associated with certain abnormalities of the organs involved.Case presentationHerein, we present a case of a situs inversus totalis woman presented with choledocholithiasis. Elective laparoscopic cholecystectomy was performed on the patient with intraoperative modifications. The patient was discharged in a healthy condition.Clinical discussionSeveral case reports have documented the typical presentation of cholelithiasis, which is characterized by pain in the left upper quadrant and epigastric region. Our patient exhibited similar symptoms and was diagnosed with choledocholithiasis.ConclusionsDiagnostic and therapeutic management of morbidities in SIT individuals can be performed with recommended modifications that can lead to favorable outcomes.

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Laparoscopic cholecystectomy in a patient with situs inversus totalis: case report with review of literature.

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Endoscopic submucosal dissection of early gastric cancer in a patient with situs inversus totalis.

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