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Laparoscopic Cholecystectomy in Situs Inversus Totalis: A Case Report.

Prapti Lakhey1, Milan Shrestha2, Rishav Sharma3

  • 1Third Year Medical Student Nepal Medical College Teaching Hospital Kathmandu Nepal.

Clinical Case Reports
|February 19, 2025
PubMed
Summary

Situs inversus totalis, a rare condition, complicates gallbladder diagnosis and surgery. This report details a successful laparoscopic cholecystectomy in a patient with this condition, highlighting necessary adaptations for safe procedures.

Keywords:
ergonomicslaparoscopic cholecystectomysitus inversus totalis

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Area of Science:

  • Medical Case Reports
  • Surgical Innovation
  • Anatomical Variations

Background:

  • Situs inversus totalis is a rare congenital condition where major visceral organs are mirrored.
  • This anatomical anomaly presents diagnostic and surgical challenges, particularly for gallbladder-related conditions.
  • Gallbladder pathology in situs inversus totalis requires specialized approaches due to atypical organ placement.

Purpose of the Study:

  • To report a case of symptomatic cholelithiasis in a patient with situs inversus totalis.
  • To describe the successful management of this condition using laparoscopic cholecystectomy.
  • To discuss the technical challenges and necessary modifications for performing laparoscopic cholecystectomy in situs inversus totalis patients.

Main Methods:

  • Case presentation of a 30-year-old female with situs inversus totalis and symptomatic cholelithiasis.
  • Performance of laparoscopic cholecystectomy with specific adaptations for the patient's anatomy.
  • Perioperative management and post-operative follow-up.

Main Results:

  • The patient was diagnosed with symptomatic cholelithiasis despite the challenges posed by situs inversus totalis.
  • Laparoscopic cholecystectomy was successfully performed with an uneventful post-operative recovery.
  • The case highlights the feasibility of advanced laparoscopic procedures in patients with significant anatomical variations.

Conclusions:

  • Symptomatic cholelithiasis can occur in patients with situs inversus totalis and is amenable to surgical treatment.
  • Laparoscopic cholecystectomy in situs inversus totalis is technically demanding but achievable with careful planning and modifications.
  • This case underscores the importance of tailored surgical strategies for rare anatomical variations to ensure patient safety and optimal outcomes.