Situs Inversus Totalis: Laparoscopic Cholecystectomy and Some Modifications

Laparoscopic cholecystectomy has become the standard approach since its introduction in 1987 by Mouret. Situs inversus totalis is a rare anomaly in which transposition of the organ to the opposite site of the body occurs. Laparoscopic cholecystectomy due to gall stone disease in such few cases has been reported in the literature. The presentation of the cholecystitis, its diagnosis and the operative procedure can pose problems. Laparoscopic cholecystectomy in those patients is technically more demanding and needs reorientation of visual motor skill to left upper quadrant. We present here two such cases and difficulties encountered during surgery with some modification of the procedure to cope with the situation. The case study was done in April, 2014 and May, 2014 respectively in Islamic Bank Central Hospital Kakrail, Dhaka.