Situs inversus - JSLS

Acute Appendicitis in a Patient With Situs Inversus Totalis and Malrotation

SLS — Fri, 17 May 2019 14:03:59 +0000

Margaret L. Jackson, MD, Shinil K. Shah, DO, FACS, Amit K. Agarwal, MD, FACS

Department of Surgery, University of Texas McGovern Medical School, Houston, Texas (all authors).

ABSTRACT

Left-sided acute appendicitis is a rare condition that occurs most frequently in patients with congenital abnormalities. It can be a surgical emergency and a diagnostic challenge for clinicians. We present a case of acute appendicitis in a patient with situs inversus totalis and intestinal malrotation.

Key Words: left-sided appendicitis, malrotation, situs inversus.

[gview file=”https://crsls.sls.org/wp-content/uploads/2019/05/jls102193774001.pdf”]

The post Acute Appendicitis in a Patient With Situs Inversus Totalis and Malrotation first appeared on JSLS.

Single-Site “Marionette” Approach to Situs Inversus Cholecystectomy

SLS — Thu, 13 Sep 2018 21:05:55 +0000

Lee Stratton, MD, Justin Gerard, MD, Allison G. McNickle, MD, Steven R. Bonomo, MD

Department of Surgery, Mount Sinai Hospital Medical Center, Chicago, Illinois (Dr Stratton), Department of Surgery, Rush University Medical Center, Chicago, Illinois (Dr Gerard), Department of Surgery, University of Nevada–Las Vegas School of Medicine, Las Vegas, Nevada (Dr McNickle), Department of Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois (Dr Bonomo).

ABSTRACT

Introduction: Situs inversus totalis is a rare congenital condition that involves sagittal mirroring of all thoracic and abdominal organs. The mirrored anatomy poses a challenge to the surgeon performing intra-abdominal surgery. Several laparoscopic techniques have been described for cholecystectomy in these patients.

Case Description: A 50-year-old woman with situs inversus totalis presented with left upper quadrant pain, cholelithiasis, and clinical findings consistent with acute cholecystitis. She underwent laparoscopic cholecystectomy with a single-site, “marionette” technique. This entailed a single periumbilical incision with 2 trocars (for camera and dissecting instrument) with suture suspension of the infundibulum, body, and fundus of the gallbladder, to facilitate manipulation and visualization.

Discussion: Several case reports have described safe completion of laparoscopic cholecystectomy in the setting of situs inversus totalis by using either mirroring of the traditional 4-port arrangement or a single port, multichannel apparatus. This article describes a single-site, marionette technique that circumvents many of the ergonomic and technical short- comings of approaches described elsewhere.

Key Words: Gallbladder, Situs Inversus, Single-Site Laparoscopic Cholecystectomy.

[gview file=”https://crsls.sls.org/wp-content/uploads/2018/09/jls102183700001.pdf”]

The post Single-Site “Marionette” Approach to Situs Inversus Cholecystectomy first appeared on JSLS.

Laparoscopic Cholecystectomy in Patients with Situs Inversus Totalis

SLS — Fri, 14 Nov 2014 15:46:58 +0000

Basmah Amin Rafie, MS, MRCS, Omar Jamil AbuHamdan, MS, PhD

Department of General Surgery, Hera General Hospital, Makkah, Kingdom of Saudi Arabia (all authors).

ABSTRACT

Situs inversus totalis (SIT) is a rare congenital anomaly characterized by complete transposition of abdominal and thoracic organs. Change in anatomical disposition of the organs not only influences the location of symptoms and signs arising from a diseased organ, but also imposes special demands on the diagnostic and surgical skills of the surgeon. We discuss two cases of SIT, outline how the diagnoses were made, and describe the pitfalls encountered during the surgery and how they were overcome. Although there is no current evidence supporting the increased incidence of cholelithiasis in patients with SIT, reports have shown that symptomatic gall bladder disease in these patients can be successfully and safely treated laparoscopically.

Key Words: Situs inversus, Laparoscopic cholecystectomy.

[gview file=”https://crsls.sls.org/wp-content/uploads/2014/11/13-00018.pdf”]

The post Laparoscopic Cholecystectomy in Patients with Situs Inversus Totalis first appeared on JSLS.