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Effective Port Placement for Left Sided Gallbladder Cholecystectomy.

Joel Braverman¹, Kristine Makiewicz¹

¹Department of Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL.

CRSLS : MIS Case Reports From SLS

|January 30, 2023

Summary

Left-sided gallbladder (sinistroposition) presents a surgical challenge. This case demonstrates that standard port placement can allow for safe and effective laparoscopic cholecystectomy, even with this rare anomaly.

Keywords:

Laparoscopy Left-sided gallbladder Port placement Sinistroposition of the gallbladder Situs inversus

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Area of Science:

Surgical Anatomy
Minimally Invasive Surgery
Congenital Anomalies

Background:

Left-sided gallbladder (sinistroposition) is a rare congenital anomaly.
It can complicate laparoscopic cholecystectomy, particularly with standard port placement.

Observation:

A 36-year-old woman presented with biliary colic and underwent elective cholecystectomy.
Intraoperatively, a left-sided gallbladder (sinistroposition) was identified after initial port placement.

Findings:

The laparoscopic cholecystectomy was completed successfully using a standard port configuration.
The surgeon's right-hand port at Palmer's point provided optimal positioning for dissection, without altering other port placements.

Implications:

Standard port placement, including a port at Palmer's point, can be effective for sinistropositional gallbladder dissection.
This approach facilitates familiar surgical angles, simplifying the identification of biliary anatomy despite the anomaly.