Laparoscopic Cholecystectomy In Situs Inversus Totalis (SIT): A Case Series - Modified French Technique Provides...

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery
• Congenital Anomalies

Background:

• Situs inversus totalis (SIT) is a rare congenital condition with mirrored organ placement.
• Patients with SIT and gallstones present unique surgical challenges, especially for laparoscopic cholecystectomy (LC).
• Reversed anatomy in SIT complicates standard surgical approaches and orientation.

Purpose of the Study:

• To evaluate the safety and feasibility of laparoscopic cholecystectomy (LC) in patients with situs inversus totalis (SIT).
• To identify necessary modifications for performing LC in patients with reversed anatomy.
• To assess outcomes of LC in SIT patients compared to standard procedures.

Main Methods:

• Retrospective review of 12 patients with SIT undergoing LC.
• Preoperative assessments included laboratory tests and imaging.
• Modified French technique with mirror-image port placement and harmonic scalpel used.

Main Results:

• 12 LCs performed in SIT patients (0.22% prevalence) out of 5375 total LCs.
• All procedures were completed laparoscopically without conversion.
• No intraoperative complications, bile duct injuries, or mortality; one case required port modification.

Conclusions:

• Laparoscopic cholecystectomy is safe and feasible in SIT patients with experienced surgical teams.
• Adaptations in surgical technique and port positioning are crucial for managing reversed anatomy.
• Thorough preoperative planning and intraoperative awareness ensure successful outcomes.