scholarly journals Laparoscopic Sigmoidectomy for a Patient With Situs Inversus Totalis: Effect of Changing Operator Position

2015 ◽  
Vol 100 (4) ◽  
pp. 638-642 ◽  
Author(s):  
Mizunori Yaegashi ◽  
Toshimoto Kimura ◽  
Takashi Sakamoto ◽  
Tadao Sato ◽  
Yuichiro Kawasaki ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Situs Inversus ◽  
Operating Time ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Laparoscopic Sigmoidectomy ◽  
Vascular Abnormalities ◽  
Congenital Condition ◽  
Well Differentiated ◽  
The Right

Situs inversus totalis (SIT) is a rare congenital condition in which the abdominal and thoracic organs are on the opposite sides to their normal anatomic positions. Reports of laparoscopic surgery for colorectal cancer with SIT are very few. Due to the mirror-image transposition of organs and vascular abnormalities, laparoscopic surgery for patients with SIT is technically complicated. Therefore, it has been reported as easier for left-handed surgeons. This report presents that operative procedures can be conducted as usual by changing the positions of the operator and assistants, even if the operator is right-handed. A 71-year-old woman visited our hospital with a 2-month history of hematochezia. Colonoscopy revealed an ulcerative tumor in the sigmoid colon and biopsy confirmed well-differentiated adenocarcinoma. Laparoscopic sigmoidectomy radical lymphadenectomy was performed. The operating time was 189 minutes and blood loss was 13 mL. The patient was discharged on postoperative day 7, without any complications. We report that complicated surgical procedures for patients with SIT can be simplified by changing viewpoints. Due to the altered anatomy in SIT, the positions of the operator and assistants are very important. Location of the pelvis is almost the same as in orthotopic patients, by moving the operator from the left side to the right side of the patient. Changing the position of the operator to the right side seems to be effective for patients with SIT during pelvic procedures.

Situs Inversus Totalis

2001 ◽  
Vol 20 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Janie Spoon
Keyword(s):  
Situs Inversus ◽  
Vena Cava ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
The Body ◽  
Radiographic Examination ◽  
Internal Organs ◽  
Radiographic Findings ◽  
Situs Solitus ◽  
The Right

EXTERNALLY, THE HUMAN BODY appears symmetric; if a line is drawn down the middle of the body, each side appears identical. However, this is not true of the internal anatomy. For example, there is one heart, which lies in the left chest, one liver, in the right abdomen, and one stomach, in the left abdomen. The term situs refers to the position or location of an organ, specifically, the position of the atria and abdominal viscera in relation to the midline of the body.1 There are three types of situs: solitus, inversus, and ambiguous. Situs solitus refers to the normal arrangement of organs, with the right atrium, liver, gallbladder, trilobed lung, and inferior vena cava on the right side and the left atrium, stomach, spleen, bilobed lung, and descending aorta on the left side (Figures 1–3). Situs inversus totalis refers to a mirror image reversal of the normal position of the internal organs (Figures 4 and 5). 1 The incidence of situs inversus totalis is 1 in every 8,000 to 25,000 births, and the condition is most often diagnosed by radiographic examination.2Situs ambiguous, often referred to as heterotaxia, is the random arrangement of the internal organs and is associated with splenic abnormalities and congenital heart disease.3 The purpose of this column is to discuss the embryology, pathophysiology, and diagnosis of situs inversus totalis and to review a case study with radiographic findings.

scholarly journals Specificities of transplantation of kidneys procured from donors with situs inversus totalis: A case report and review of the literature

2015 ◽  
Vol 72 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Milica Petrovic ◽  
Violeta Rabrenovic ◽  
Dusica Stamenkovic ◽  
Neven Vavic ◽  
Zoran Kovacevic ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Case Report ◽  
Situs Inversus ◽  
Iliac Fossa ◽  
Preoperative Evaluation ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Image Reversal ◽  
The Right

Introduction. Situs inversus totalis (SIT) represents a total vertical transposition of the thoracic and abdominal organs which are arranged in a mirror image reversal of the normal positioning 1. We presented a successful pre-dialysis kidney transplantation from a living sibling donor with SIT and the longest donor follow-up period, along with analysis of the reviewed literature. Case report. The pair for pre-dialysis kidney transplantation included a 68-year-old mother and 34-year-old daughter at low immunological risk. Comorbidities evidenced in kidney donors with previously diagnosed SIT, included moderate arterial hypertension and borderline blood glucose level. Explantation of the left donor kidney and its placement into the right iliac fossa of the recipient were performed in the course of the surgical procedure. A month after nephrectomy, second degree renal failure was noticed in the donor. A 20-month follow-up of the donor?s kidney and graft in the recipient proved that their functions were excellent. Conclusion. In donors with previously diagnosed SIT the multidisciplinary approach, preoperative evaluation of the patient and detection of possible vascular anomalies are required to provide maximum safety for the donor.

scholarly journals Right Hemihepatectomy via an Anterior Approach for Hepatocellular Carcinoma in a Situs Inversus Totalis Patient

2020 ◽  
Vol 14 (1) ◽  
pp. 91-97
Author(s):  
Rong-Dang Fu ◽  
Jie-Yuan Li ◽  
Xiao-Hong Zhang ◽  
Huan-Wei Chen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Situs Inversus ◽  
Anterior Approach ◽  
Middle Hepatic Vein ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Right Hemihepatectomy ◽  
Glissonian Approach ◽  
Congenital Condition ◽  
Chest X Ray

Situs inversus totalis (SIT) is a rare congenital condition in which the usual position of the organs is reversed from left to right as a mirror image of the normal situation. Due to the abnormal transposition, this represents a technical challenge for the surgeon. In the present study, right hemihepatectomy via the anterior approach was performed for a 68-year-old hepatocellular carcinoma (HCC) patient with SIT. SIT was diagnosed by chest X-ray and computed tomography. The tumors were located in segments VIII and VI of the liver, and there was no metastasis to the lymph nodes and distant organs. Hemihepatic vascular inflow occlusion was performed using the selective intra-Glissonian approach. The middle hepatic vein was preserved under the guidance with intraoperative ultrasonography. The present case suggests that right hemihepatectomy via the anterior approach may be a safe, feasible, and effective procedure for HCC patients with SIT.

Situs Inversus Totalis in a Dog With a Chronic Diaphragmatic Hernia

2009 ◽  
Vol 45 (5) ◽  
pp. 245-248 ◽  
Author(s):  
Tige H. Witsberger ◽  
David I. Dismukes ◽  
Efrat Y. Kelmer
Keyword(s):  
Case Report ◽  
Diaphragmatic Hernia ◽  
Situs Inversus ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Doberman Pinscher ◽  
Clinically Normal ◽  
Normal Orientation ◽  
Congenital Condition ◽  
Thoracic And Abdominal

Situs inversus totalis is a rare, congenital condition that is characterized by the development of the thoracic and abdominal viscera in a mirror image to their normal orientation. This case report describes the condition in a 4-year-old, spayed female Doberman pinscher that was evaluated for dyspnea following sedation. Radiography confirmed a diaphragmatic hernia. Situs inversus was discovered during surgical correction. The diaphragmatic rent was repaired, and the dog was clinically normal at recheck 13 months after surgery.

Case Report of Situs Inversus Totalis and Laparoscopic Cholecystectomy

2016 ◽  
Vol 101 (7-8) ◽  
pp. 347-351 ◽  
Author(s):  
Thomas K. Duncan ◽  
Kenneth Waxman
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Situs Inversus ◽  
Epigastric Pain ◽  
Signs And Symptoms ◽  
Technical Difficulty ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
The Body ◽  
Critical View Of Safety ◽  
The Right

Laparoscopic cholecystectomy (LC) in patients with situs inversus totalis (SIT) characterized by transposition of organs to the opposite side of the body can be technically challenging. A 43-year-old Hispanic woman presented with epigastric pain radiating to the chest and back, intermittently over 3 months, but worse on day of admission. During the cardiac workup, she was noted to have dextrocardia. The patient had a left-sided Murphy's sign, propagating a workup that confirmed SIT, including an ultrasound showing cholelithiasis and normal ducts. The patient underwent an LC and was found to have choledocholithiasis. An endoscopic retrograde cholangiopancreatography cleared the common bile duct of a choledocholith. LC is the gold standard for cholecystitis. It is the second most common laparoscopic procedure conducted worldwide. When SIT is encountered, feasibility and technical difficulty in diagnosis and treatment of such cases pose challenges due to contralateral transposition of the visceral organs. Difficulty is encountered when exposing the triangle of Calot/critical view of safety and especially when conducting a cholangiogram. As such, added time is usually required to conduct the procedure. Conducting an LC in a patient with SIT is feasible when performed by an experienced laparoscopic surgeon. The diagnosis and initial presenting signs and symptoms are different from the patient with a normal anatomy. The surgical skills of the surgeon are challenged, especially in the right hand–dominant individual. The mindset of the surgeon requires changing the critical thinking when conducting a mirror image dissection.

scholarly journals Pipeline embolization device implantation in large carotid cavernous aneurysm associated with situs inversus totalis

2019 ◽  
Vol 25 (4) ◽  
pp. 434-437
Author(s):  
Sudheer Chakravarthi ◽  
Hidenori Oishi ◽  
Kenji Yatomi ◽  
Kohsuke Teranishi
Keyword(s):  
Situs Inversus ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Endovascular Management ◽  
Normal Position ◽  
Radiological Findings ◽  
Vascular Abnormalities ◽  
Device Implantation ◽  
Bilateral Carotid ◽  
Situs Solitus

Situs anomalies are a heterogenous class of inborn visceral and vascular abnormalities with a broad range of radiographic characteristics. Situs inversus totalis is characterized by mirror image location of the heart and viscera relative to situs solitus (normal position). Few aberrations involving the neuraxis, and rarely intracranial aneurysms, have been reported in association with situs inversus totalis. We describe the radiological findings and endovascular management of one of the first of its kind: the association of bilateral carotid cavernous aneurysms (one large and the other small-sized) with situs inversus totalis.

scholarly journals Off-Pump Coronary Artery Bypass Grafting in Dextrocardia with Situs Inversus Totalis – A Case Report

2016 ◽  
Vol 12 (2) ◽  
pp. 46-47
Author(s):  
Raghav Johari ◽  
M. Garg
Keyword(s):  
Coronary Artery ◽  
Situs Inversus ◽  
Artery Bypass ◽  
Situs Inversus Totalis ◽  
Operating Table ◽  
Off Pump ◽  
Congenital Condition ◽  
Pump Coronary Artery Bypass ◽  
The Right ◽  
And Function

Dextrocardia with situs inversus totalis, is a rare congenital condition. This goes undiagnosed many a times and is coincidentally diagnosed as in our case. Since individuals with this ailment have normal cardiac physiology and function, they live normal lives. We report one cases of dextrocardia (situs inversus totalis) with triple vessel coronary artery disease. To operate on patients with dextrocardia, surgeons need to make a few modifications. These include using the right internal mammary artery as a conduit for the “left” anterior descending artery, surgeons position - sometimes the operating surgeon may need to stand at the left side of the operating table or may have to come on left side for some time for positioning the heart and placing stabilizing device for optimum exposure. Pre-operative surgical difficulties which may be encountered and choice of conduits should be discussed beforehand.JNGMC Vol. 12 No. 2 December 2014, Page: 46-47

scholarly journals Laparoscopic cholecystectomy in situs inversus totalis: A case report

2021 ◽  
Vol 38 (2) ◽  
pp. 183-188
Author(s):  
Radomir Gelevski ◽  
Gjorgji Jota ◽  
Lazar Todorović ◽  
Gjorgji Trajkovski ◽  
Vladimir Joksimović ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Situs Inversus ◽  
Epigastric Pain ◽  
Genetic Defect ◽  
Operating Time ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Digestive Tube ◽  
Left Hand ◽  
Standard Position

Situs inversus totalis represents a rare autosomal recessive morphological anomaly of the internal viscera, equally affecting both genders. The genetic defect occurs in the 2nd week of embryonic life, when a 270-degree clockwise rotation of the primitive digestive tube occurs. The incidence of calculosis of gallbladder in patients with situs inversus is the same as in the general population. A 61-year-old female patient with a history of four episodes of colicky, left hypochondrium and epigastric pain, without fever and jaundice, was admitted for elective laparoscopic cholecystectomy. CT of abdomen confirmed situs inversus totalis that was previously known to the patient. The patient was positioned in supine position and a mirror image configuration of the operating room was obtained, with surgeon and scrub nurse on the right side and assistant on the left side of the patient. Four trocars were introduced mirroring the standard position of the 5 mm trocars. During the dissection, second assistant was introduced for the laparoscope, due to the surgeon's limited motor skills in his left hand for delicate dissection, rendering him inapt to perform precise and safe dissection. The total operating time amounted to 110 minutes, which is three times longer than the standard operating time at our institution. The most critical point of the operation in constellation of situs inversus totalis is applying the clips, which requires precision and strength in the same moment. In the available literature, 40 open cholecystectomies before introduction of laparoscopy and 92 laparoscopic cholecystectomies were reported. To our knowledge, this is the first and the only reported laparoscopic cholecystectomy for situs inversus in North Macedonia.

scholarly journals Endoscopic submucosal dissection of early gastric cancer via inverted overtube in a patient with situs inversus totalis: a case report

2018 ◽  
Vol 06 (05) ◽  
pp. E625-E629
Author(s):  
Youichi Miyaoka ◽  
Shinsuke Suemitsu ◽  
Aya Fujiwara ◽  
Satoshi Kotani ◽  
Kosuke Tsukano ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Situs Inversus ◽  
Gastric Fluid ◽  
Situs Inversus Totalis ◽  
Endoscopic View ◽  
Submucosal Dissection ◽  
The Right ◽  
Lesser Curvature

Abstract Background and study aims A 72-year-old man with complete situs inversus presented with early gastric cancer on the lesser curvature wall of the antrum of the stomach. Endoscopic submucosal dissection (ESD) was selected as a treatment. When the patient was positioned in the left decubitus position, the lesion was hidden by blood and gastric fluid because it was located on the gravitational side. Therefore, we decided to perform ESD with the patient in the right lateral decubitus position and use an inverted overtube, which provided a good endoscopic view without the need to rearrange the endoscopist, assistants, or endoscopic system. ESD was safe and feasible using the inverted overtube.

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