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Laparoscopic resection for rectal cancer and cholecystectomy for patient with situs inversus totalis.

Fang JF, Zheng ZH, Wei B, Chen TF, Lei PR, Huang JL, Huang LJ, Wei HB - J Minim Access Surg (2015 Jul-Sep)

Bottom Line: Situs inversus totalis (SIT) is a rare congenital anomaly presenting with complete transposition of thoracic and abdominal viscera.She was diagnosed with SIT by performing radiography and abdominal computed tomography scan as a routine preoperative investigation.One year later, she was diagnosed with cholecysticpolyp, and we performed laparoscopic cholecystectomy for her uneventfully.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.

ABSTRACT
Situs inversus totalis (SIT) is a rare congenital anomaly presenting with complete transposition of thoracic and abdominal viscera. Laparoscopic surgery for either rectal cancer or gallbladder diseases with SIT is rarely reported in the literature. A 39-year-old woman was admitted to hospital owing to rectal cancer. She was diagnosed with SIT by performing radiography and abdominal computed tomography scan as a routine preoperative investigation. We performed laparoscopic resection for rectal cancer successfully in spite of technical difficulties caused by abnormal anatomy. One year later, she was diagnosed with cholecysticpolyp, and we performed laparoscopic cholecystectomy for her uneventfully. With this case, we believe that performance by an experienced laparoscopic surgeon, either laparoscopic resection for rectal cancer or cholecystectomy with SIT is safe and feasible.

No MeSH data available.


Related in: MedlinePlus

Ligation of inferior mesenteric vessel.
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Figure 2: Ligation of inferior mesenteric vessel.

Mentions: In spite of potential technical difficulties caused by abnormal anatomy, we decided to perform a laparoscopic procedure for her. Informed consent was signed, and laparoscopic resection for rectal cancer was performed in July 2012. The operation was performed under general anesthesia, and the patient was placed in lithotomy position. Contrary to usual laparoscopic resection for rectal cancer, the right-handed surgeon and camera surgeon were positioned on the left side of the patient, while the first assistant surgeon was on the right. Pneumoperitoneum was established using the veress needle technique. A 10-mm port, below the umbilicus for a 30° telescope, was first inserted. Another three trocars were placed for manipulation at the opposite site of McBurney's point, left and right lateral side of the rectus abdominis at the level of umbilicus, respectively. Laparoscopic exploration showed complete transposition of abdominal viscera: The stomach and spleen were located in the right upper abdomen, whereas the liver and gall bladder were in the left upper abdomen, and sigmoid colon was in the right lower abdomen. The sigmoid mesocolon and mesorectum were dissected along the inner side of the ureter by harmonic scalpel, and inferior mesenteric artery was explored on the left side of the vein. The vessel and lymphatic vessel were ligated at the root of the inferior mesenteric vessel with polymer clips [Figure 2]. Then the rectum was transected, and finally, the sigmoidorectostomy was completed with a 29 mm intraluminal stapler intracorporeally.


Laparoscopic resection for rectal cancer and cholecystectomy for patient with situs inversus totalis.

Fang JF, Zheng ZH, Wei B, Chen TF, Lei PR, Huang JL, Huang LJ, Wei HB - J Minim Access Surg (2015 Jul-Sep)

Ligation of inferior mesenteric vessel.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499930&req=5

Figure 2: Ligation of inferior mesenteric vessel.
Mentions: In spite of potential technical difficulties caused by abnormal anatomy, we decided to perform a laparoscopic procedure for her. Informed consent was signed, and laparoscopic resection for rectal cancer was performed in July 2012. The operation was performed under general anesthesia, and the patient was placed in lithotomy position. Contrary to usual laparoscopic resection for rectal cancer, the right-handed surgeon and camera surgeon were positioned on the left side of the patient, while the first assistant surgeon was on the right. Pneumoperitoneum was established using the veress needle technique. A 10-mm port, below the umbilicus for a 30° telescope, was first inserted. Another three trocars were placed for manipulation at the opposite site of McBurney's point, left and right lateral side of the rectus abdominis at the level of umbilicus, respectively. Laparoscopic exploration showed complete transposition of abdominal viscera: The stomach and spleen were located in the right upper abdomen, whereas the liver and gall bladder were in the left upper abdomen, and sigmoid colon was in the right lower abdomen. The sigmoid mesocolon and mesorectum were dissected along the inner side of the ureter by harmonic scalpel, and inferior mesenteric artery was explored on the left side of the vein. The vessel and lymphatic vessel were ligated at the root of the inferior mesenteric vessel with polymer clips [Figure 2]. Then the rectum was transected, and finally, the sigmoidorectostomy was completed with a 29 mm intraluminal stapler intracorporeally.

Bottom Line: Situs inversus totalis (SIT) is a rare congenital anomaly presenting with complete transposition of thoracic and abdominal viscera.She was diagnosed with SIT by performing radiography and abdominal computed tomography scan as a routine preoperative investigation.One year later, she was diagnosed with cholecysticpolyp, and we performed laparoscopic cholecystectomy for her uneventfully.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.

ABSTRACT
Situs inversus totalis (SIT) is a rare congenital anomaly presenting with complete transposition of thoracic and abdominal viscera. Laparoscopic surgery for either rectal cancer or gallbladder diseases with SIT is rarely reported in the literature. A 39-year-old woman was admitted to hospital owing to rectal cancer. She was diagnosed with SIT by performing radiography and abdominal computed tomography scan as a routine preoperative investigation. We performed laparoscopic resection for rectal cancer successfully in spite of technical difficulties caused by abnormal anatomy. One year later, she was diagnosed with cholecysticpolyp, and we performed laparoscopic cholecystectomy for her uneventfully. With this case, we believe that performance by an experienced laparoscopic surgeon, either laparoscopic resection for rectal cancer or cholecystectomy with SIT is safe and feasible.

No MeSH data available.


Related in: MedlinePlus