Open Cholecystectomy in a Patient With Situs Inversus Totalis and Symptomatic Cholelithiasis: A Case Report

Area of Science:

• Surgical anatomy
• Gastrointestinal surgery
• Medical imaging

Background:

• Situs inversus totalis (SIT) presents unique anatomical challenges for surgical procedures.
• Standard surgical landmarks are reversed in SIT patients, increasing operative risks.
• Cholecystectomy in SIT requires specialized planning and execution.

Purpose of the Study:

• To describe the surgical strategy for performing cholecystectomy in patients with SIT.
• To highlight the importance of preoperative imaging and intraoperative safety measures.
• To evaluate the safety and feasibility of open cholecystectomy in SIT.

Main Methods:

• Preoperative imaging to delineate reversed anatomy.
• Development of a mirror-image surgical strategy.
• Adherence to critical view of safety principles.
• Performance of open cholecystectomy via a left subcostal incision.

Main Results:

• Successful open cholecystectomy was performed despite visceral transposition.
• Careful preoperative imaging and mirror-image surgical planning were crucial.
• Achievement of the critical view of safety was maintained throughout the procedure.

Conclusions:

• Open cholecystectomy can be safely accomplished in SIT patients.
• Meticulous preoperative assessment and tailored surgical techniques are essential for favorable outcomes.
• SIT does not preclude safe and effective cholecystectomy when appropriate measures are taken.