Challenges and Considerations in Performing Laparoscopic Cholecystectomy in a Patient with Total Situs Inversus a Case Report
DOI:
https://doi.org/10.14738/bjhr.1202.18709Keywords:
french mirror technique, american mirror technique, cholelithiasis, laparoscopic cholecystectomy, total situs inversusAbstract
Laparoscopic cholecystectomy plays a central role in the treatment of patients with gallstones and is the gold standard for the management. Total situs inversus (TSI) is a rare congenital anomaly in which there is a transposition of the thoracic and abdominal organs, resulting in a mirror-image left-right configuration of the normal anatomical placement of organs. TSI affects less than 0.01% of the population. We present a case of a 68-year-old male with cholelithiasis and TSI, managed with laparoscopic cholecystectomy using the American mirror technique for cholecystectomy in such patients, reporting favorable outcomes for the patient. In conclusion, bibliographic reports and our personal experience in this case emphasize that the unique anatomical disposition in TSI requires modifications to the surgical technique, necessitating a well-trained surgeon with a deep understanding of biliary anatomy and its variations.
References
Pisano, M., Allievi, N., Gurusamy, K. et al. 2020 Pautas actualizadas de la Sociedad Mundial de Cirugía de Emergencia para el diagnóstico y tratamiento de la colecistitis litiásica aguda. World J Emerg Surg 15 , 61 (2020). https://doi.org/10.1186/s13017-020-00336-x
Lakhey P, Shrestha M, Sharma R, Lakhey PJ. Laparoscopic Cholecystectomy in Situs Inversus Totalis: A Case Report. Clin Case Rep. 2025 Feb 18;13(2):e70222. doi: 10.1002/ccr3.70222. PMID: 39967839; PMCID: PMC11833166.
Situs inversus totalis: revisión de tema con aproximación a la Genética y reporte de casos. Aljure Reales VJ, Álvarez Gallego GC, Ávila Espitia NC, Coleyb AA, Ángel Suárezb OG. Rev. Colomb Cardiol. 2017;24:40–47.
Situs inversus totalis en el entorno neonatal. Devera J, Licandro F, Ramos J, Taymoorian HT, Yap LG. Cureus. 2021;13:0. doi: 10.7759/cureus.13516.
Eitler K., Bibok A. y Telkes G., “Situs Inversus Totalis: A Clinical Review”, International Journal of General Medicine 15 (2022): 2437–2449.
Meza-Martinez DA, Palomino-Payan JA, Andrade-Ordoñez SJ, Fematt-Rodriguez BJ, Muñuzuri-Camacho MA, Gonzalez-Quezada A. Overcoming Anatomical Challenges: Laparoscopic Cholecystectomy in Situs Inversus Totalis. Cureus. 2023 Oct 2;15(10):e46371. doi: 10.7759/cureus.46371. PMID: 37800165; PMCID: PMC10549780.
Campos L., Sipes E. Colecistectomía laparoscópica en una mujer de 39 años con situs inversus. J. Laparoendosc. Surg. 1991;1:123–126. doi: 10.1089/lps.1991.1.123.
Du T, Hawasli A, Summe K, Meguid AA, Lai C, Sadoun M. Laparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis: Port Placement and Dissection Techniques. Am J Case Rep. 2020 Sep 4;21:e924896. doi: 10.12659/AJCR.924896. PMID: 32886654; PMCID: PMC7491955.
Carroll BJ. "Laparoscopic cholecystectomy: the American technique." Operative strategies in laparoscopic surgery. Springer, Berlin: Heidelberg; 1995: 34–38.
Dubois F. "Laparoscopic cholecystectomy: the French technique." Operative strategies in laparoscopic surgery. Springer, Berlin: Heidelberg; 1995: 30–33.
Mohamed Ali Chaouch, Hichem Jerraya, Mohamed Wejih Dougaz, Ramzi Nouira & Chadli Dziri (2019): A Systematic Review of Laparoscopic Cholecystectomy in Situs Inversus, Journal of Investigative Surgery, DOI: 10.1080/08941939.2019.1622822.Heneghan, C., et al., Characterization of changes in blood vessel width and tortuosity in retinopathy of prematurity using image analysis. Medical image analysis, 2002. 6(4): p. 407-429.
Enciu O, Toma EA, Tulin A, Georgescu DE, Miron A. Look beyond the Mirror: Laparoscopic Cholecystectomy in Situs Inversus Totalis-A Systematic Review and Meta-Analysis (and Report of New Technique). Diagnostics (Basel). 2022 May 19;12(5):1265. doi: 10.3390/diagnostics12051265. PMID: 35626419; PMCID: PMC9140146.Narasimha-Iyer, H., et al., Automatic Identification of Retinal Arteries and Veins from Dual-Wavelength Images Using Structural and Functional Features. Biomedical Engineering, IEEE Transactions on, 2007. 54(8): p. 1427-1435.
Strasberg SM, Brunt LM La visión crítica de la seguridad. Ann. Surg. 2017;265:464–465. doi: 10.1097/SLA.0000000000002054.Foracchia, M., Extraction and quantitative description of vessel features in hypertensive retinopathy fundus images, in Book Abstracts 2nd Int. Workshop on Computer Assisted Fundus Image Analysis, E. Grisan, Editor 2001. p. 6-6.
Barbara L., Sama C., Labate AMM, Taroni F., Rusticali AG, Festi D., Sapio C., Roda E., Banterle C., Puci A., et al. Un estudio poblacional sobre la prevalencia de la enfermedad de cálculos biliares: el estudio Sirmione. Hepatología. 1987;7:913–917. doi: 10.1002/hep.1840070520.
Situs inversus totalis: reporte de un caso Fragoso-Sánchez JA, Castillo-Ramírez L, Sernas-Romero N. http://revistamedica.imss.gob.mx/editorial/index.php/revista_medica/article/view/173/441 . Rev Med Inst Mex Seguro Soc. 2015;53:652–655.
Situs inversus totalis: una revisión clínica. Eitler K, Bibok A, Telkes G. Int J Gen Med. 2022;15:2437–2449. doi: 10.2147/IJGM.S295444.
Colecistectomía y situs inversus totalis (con video) Meskauskas A, Trésallet C, Siebert M. SODA. 2023;9:100069.
Revisión sistemática de la colecistectomía laparoscópica en el sitio inverso. Chaouch MA, Jerraya H, Dougaz MW, Nouira R, Dziri C. J Invest Surg. 2021;34:324–333. doi: 10.1080/08941939.2019.1622822.
Comorbilidades en el situs inversus totalis: un estudio en un hospital. Chen W, Guo Z, Qian L, Wang L. Birth Defects Res. 2020;112:418–426. doi: 10.1002/bdr2.1652
Paciente con situs inversus totalis que se presenta para una apendicectomía laparoscópica de urgencia: consideraciones para un manejo anestésico seguro. Channabasappa SM, Mohan HS, Sarma J. Anesth Essays Res. 2013;7:127–129. doi: 10.4103/0259-1162.114019.
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Copyright (c) 2025 Flores Gonzalez CJ, Gonzàlez Martinez AU, Durango Hernandez DJ, Lopez Bernal CA, Mendoza Rodriguez R, Hernandez Molina MP, Montes Salas JMH
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