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Updated: Sep 16, 2025

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Robot-Assisted Gastrectomy and Sigmoid Colectomy with Situs Inversus Totalis: A Case Report.

Midori Hara1, Yoshinobu Ikeno1, Junya Kobayashi1

  • 1Department of Gastrointestinal Surgery, Fukui Red Cross Hospital, Fukui, Fukui, Japan.

Surgical Case Reports
|July 8, 2025
PubMed
Summary

This study reports the first simultaneous robot-assisted gastrectomy and sigmoid colectomy in a patient with situs inversus totalis. The successful procedure highlights the feasibility of robotic surgery for complex anatomical variations.

Keywords:
robot assisted gastrectomyrobot assisted sigmoid colectomysitus inversus totalis (SIT)

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Congenital Disorders

Background:

  • Situs inversus totalis is a rare congenital condition with mirror-image organ transposition.
  • Surgical management of situs inversus totalis presents unique challenges due to anatomical abnormalities.
  • Robot-assisted surgery offers potential benefits for complex cases, but specific procedures remain underreported.

Observation:

  • A 77-year-old female with situs inversus totalis presented with concurrent gastric and sigmoid colon cancer.
  • The patient underwent simultaneous robot-assisted gastrectomy and sigmoid colectomy.
  • Standard port positions were adapted, with the robot repositioned for each procedure.

Findings:

  • The combined robot-assisted gastrectomy and sigmoid colectomy were successfully completed.
  • The patient experienced an uneventful postoperative recovery.
  • While gastrectomy was straightforward, sigmoid colectomy required careful dissection near the inferior mesenteric artery root.

Implications:

  • This case demonstrates the feasibility of performing simultaneous robot-assisted gastrectomy and sigmoid colectomy in patients with situs inversus totalis.
  • Port repositioning strategies can overcome challenges in robotic surgery for complex anatomical variations.
  • Further research and technique refinement are warranted to optimize robotic approaches for situs inversus totalis.