Two Cases of Single-Incision Laparoscopic Surgery for Sigmoid Colon and Rectal Cancer in Situs Inversus Totalis

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Situs inversus totalis (SIT) presents unique challenges in abdominal surgery due to complete visceral transposition.
• Laparoscopic procedures for sigmoid colon and rectal cancers are complicated by SIT.
• No prior reports exist on single-incision laparoscopic surgery (SILS) for sigmoid or rectal cancer in SIT patients.

Observation:

• SILS was successfully performed on two patients with sigmoid colon and/or rectal cancer and SIT.
• Case 1: A 64-year-old woman with sigmoid colon cancer underwent SILS with a 3.5 cm umbilical incision and a single-port device.
• Case 2: An 81-year-old man with sigmoid colon and rectal cancer underwent SILS combined with transanal total mesorectal excision (TaTME).

Findings:

• Both patients tolerated SILS well, with no postoperative complications.
• Resection and double-stapling anastomosis were performed in Case 1; laparoscopic anastomosis with single-stapling in Case 2.
• Both patients remained recurrence-free at 42 and 7 months post-surgery, respectively.

Implications:

• SILS is a feasible and safe surgical approach for sigmoid colon and rectal cancers in patients with situs inversus totalis.
• This study demonstrates the potential of SILS to overcome anatomical challenges posed by SIT.
• Further research may expand SILS application in complex surgical cases with rare congenital anomalies.