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Laparoscopic vs. Robotic Gastrectomy in Patients with Situs Inversus Totalis: A Systematic Review.

Anmol Multani¹, Simran Parmar², Elijah Dixon²

¹Kansas City University - College of Medicine, Joplin, MO, USA.

Minimally Invasive Surgery

|March 13, 2023

Summary

Robotic and laparoscopic gastrectomy are safe for situs inversus totalis (SIT) patients. Robot-assisted surgery showed significantly lower intraoperative blood loss compared to laparoscopy in SIT patients.

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Area of Science:

Surgical Oncology
Minimally Invasive Surgery
Medical Genetics

Background:

Situs inversus totalis (SIT) is a rare condition with mirrored organ placement.
This anatomical variation presents unique challenges for surgical procedures.
Gastrectomy in SIT patients requires careful consideration of reversed anatomy.

Purpose of the Study:

To compare perioperative outcomes and safety of robotic versus laparoscopic gastrectomy in SIT patients.
To evaluate the efficacy of minimally invasive approaches in complex anatomical variations.
To identify potential advantages of robotic surgery in SIT cases.

Main Methods:

Systematic review of case reports and brief reviews of SIT patients undergoing gastrectomy (2011-2021).
Inclusion criteria: age ≥21, laparoscopic or robotic gastrectomy, English language.

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Exclusion criteria: open gastrectomy, gastric banding, gastric bypass.

Main Results:

30 cases included: 21 laparoscopic, 9 robot-assisted.
No significant difference in operative time or hospital stay.
Robot-assisted gastrectomy demonstrated significantly lower intraoperative blood loss (p=0.0293).
Minimal postoperative complications reported, primarily in laparoscopic cases.

Conclusions:

Both laparoscopic and robotic gastrectomy are feasible and safe for SIT patients with careful planning.
Robotic approach may offer enhanced safety due to improved visualization and instrument stability.
Further research is warranted to explore robotic surgery's advantages in SIT patients.