Laparoscopic Sleeve Gastrectomy in a Patient With Situs Inversus: A Case Report

Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric surgery worldwide and is an effective treatment for obesity. Situs inversus (SI) is an uncommon congenital abnormality characterised by the anatomical location of organs within the body; it presents a rare technical challenge for bariatric surgeons due to the cognitive dissonance associated with operating on patients with mirror-image anatomy. Though even rarer, some of these patients may present with features of heterotaxy, which is defined by the abnormal arrangement of organs that comprises variants such as polysplenia. Considering the rarity of this condition, particularly in the context of bariatric surgery, our experience may provide valuable insight into the surgical approach for others who may encounter similar scenarios. We present a case of a 24-year-old female patient with SI presenting for elective LSG, with particular emphasis on the surgical technique that allowed us to successfully perform this procedure in the setting of reversed visceral anatomy. While no single approach can be universally recommended for SI, our described approach was successful and may assist surgeons who encounter these cases infrequently, particularly in centres without prior experience in mirror-image bariatric surgery.