Laparoscopic cholecystectomy in a patient with situs inversus totalis: feasibility and technical difficulties

Situs inversus is a rare anomaly characterized by transposition of organs to the opposite side of the body. In patients with this anomaly, cholelithiasis is observed with a frequency similar to that in the normal population. Herein, we report on a patient with situs inversus totalis who underwent laparoscopic cholecystectomy for mucocele of the gallbladder. Diagnostic pitfalls and technical difficulties of the operation with technical options are discussed in the context of the available literature. Difficulty is encountered particularly in skeletonizing the structures in Calot's triangle, which consumes extra time and is more demanding than in patients with a normally located gallbladder. A summary of an additional 32 similar cases reported in the medical literature is also presented.