Laparoscopic cholecystectomy in situs inversus totalis-surgical technique and procedure safety using anatomical checkpoints.

Abstract

Situs inversus totalis (SIT) is a rare congenital condition in which there is complete transposition of both the thoracic and abdominal viscera. Given how infrequently this abnormality is encountered, operating on patients with SIT can be technically difficult and challenging for the surgeon. This case report outlines the steps used to successfully carry out a laparoscopic cholecystectomy on a patient with SIT. The aim of this report is to highlight the technical difficulties encountered during this common surgical procedure. By sharing our operative experience, we hope to assist operating surgeons in their perioperative planning when faced with a similar case. Our approach to port placement, dissection of Calot's triangle, and achieving adequate tissue tension is discussed. Ultimately, we believe that advanced planning, anticipation of likely challenges, and knowledge of strategies to overcome these can only be beneficial to the safety of performing laparoscopic cholecystectomy in a patient with SIT.