Single-Site Laparoscopic Colectomy in a Patient With Situs Inversus Totalis
Yasuo Sumi, MD, PhD, Takeru Matsuda, MD, PhD, Kimihiro Yamashita, MD, PhD, Hiroshi Hasegawa, MD, PhD, Taro Oshikiri, MD, PhD, Tetsu Nakamura, MD, PhD, Satoshi Suzuki, MD, PhD, Yoshihiro Kakeji, MD
Division of Minimally Invasive Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan (Dr Sumi).
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan (Matsuda, Yamashita, Hasagawa, Oshikiri, Nakamura, Suzuki, and Kakeji).
Introduction: Situs inversus totalis (SIT) is a rare congenital anomaly in which the abdominal and thoracic cavity structures are located opposite to their usual positions. Occasionally, patients with SIT, who have malignant tumors, are encountered. Recently, several laparoscopic operations have been reported in patients with SIT.
Case Description: We report a case of a 74-year-old woman with SIT who developed cecum cancer. Single-site laparoscopic colectomy (SSLC) with radical lymphadenectomy was successfully performed with careful consideration of the mirror-image anatomy. The techniques themselves were not different from those used in ordinary cases.
Conclusion: Thus, SSLC for colon cancer in a patient with SIT can be performed safely by a skilled surgeon after thorough preoperative planning, including assessment of the anomaly. This procedure therefore remains a feasible option, even for patients with SIT, allowing them to benefit from minimally invasive surgery.
Key Words: Right colon cancer, Single-site laparoscopic surgery, Situs inversus totalis.