Abstract
BackgroundSitus inversus totalis is a relatively rare congenital anomaly. Performing the retrolaparoscopic adrenalectomy for the patient with situs inversus totalis is a skill-demanding and challenging surgical task, which has been even more rarely reported.Case presentationWe present a case with a large right adrenal mass (10.2 × 9.4 × 7.9 cm) complicated by situs inversus totalis. This 59-year-old female patient underwent the retrolaparoscopic adrenalectomy in our department. In order to facilitate the surgical orientation and improve the manipulating accuracy, the data from computed tomography images was extracted and the three-dimensional digital model was reconstructed. Under the assistance of preoperative planning and intraoperative navigation by the three-dimensional digital model, the retrolaparoscopic adrenalectomy was technically precise and successful. The targeted adrenal tumor was excised completely with final pathological diagnosis of adrenocortical adenoma.ConclusionsRetrolaparoscopic adrenalectomy can be performed safely in patients with situs inversus totalis. The assistance of preoperative planning and intraoperative navigation by the reconstructed three-dimensional digital model can facilitate the operation and lead to more precise vessel manipulation and accurate excision of tumor that is both effective and safe.
Highlights
Situs inversus totalis is a relatively rare congenital anomaly
Situs inversus totalis (SIT) is a relatively rare congenital anomaly characterized by the complete mirror-imaged visceral organs in the opposite anatomic positions [1], and its incidence was reported to be in the range of 1:10000 to 1:20000 [2]
There are only four published papers that described the laparoscopic adrenalectomy for adrenal mass in the patients with SIT [3,4,5,6], but they were all finished via the transperitoneal approach
Summary
Retrolaparoscopic adrenalectomy can be performed safely in patients with SIT. The assistance of preoperative planning and intraoperative navigation by the reconstructed 3D-DM can facilitate the operation and lead to more precise vessel manipulation and accurate excision of tumor that is both effective and safe. Abbreviations 3D-DM: Three-dimensional digital model; CT: Computed tomography; DICOM: Digital Imaging and Communications in Medicine; SIT: Situs inversus totalis. Availability of data and materials All data generated or analyzed during this study are included in this manuscript. Authors’ contributions DW was the main surgeon of the operation and conceived of the study. All authors read and approved the final manuscript. Ethics approval and consent to participate The study was approved by the institutional ethics board of the First Hospital of Shanxi Medical University. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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