title: Laparoscopic Nissen Rossetti fundoplication in situs inversus totalis-A blessing in disguise.
abstract: BACKGROUND
  Laparoscopic Nissen fundoplication and Nissen Rossetti fundoplication represent two different surgical approaches for treating hiatus hernia. We report a Laparoscopic Nissen Rossetti fundoplication (LNRF) for gastro esophageal reflux disease (GERD) in a patient with situs inversus totalis (SIT).
  
  
  METHODS
  A 38-year-old man with SIT was diagnosed with sliding hiatus hernia. We performed Laparoscopic Nissen Rossetti procedure for this patient. The patient was discharged on first postoperative day after he tolerated oral liquids.
  
  
  CONCLUSIONS
  SIT is a rare anomaly presenting in 1-2 per 10,000 individuals. As this rare anomaly (SIT) led preoperative anticipation of respiratory and blood loss complications the above procedure was chosen. Less operating time, less calculated blood loss and improvement of symptoms with no associated gas bloating syndrome was noted especially with SIT.
  
  
  CONCLUSIONS
  We recommend relook into the Laparoscopic Nissen Rossetti fundoplication as an effective procedure in GERD especially with rare anomalies like SIT.
authors.affiliation: Consultant General, Laparoscopic and Endoscopic Surgeon, Mehta Hospitals, Chennai, India. Electronic address: kaundinyakiran@gmail.com.
authors.forename: Kaundinya Kiran
authors.initials: KK
authors.lastname: Bharatam
authors.affiliation: Mehta Hospital, Chennai, India.
authors.forename: Manuneethi
authors.initials: M
authors.lastname: Maran
authors.affiliation: Sri Ramachandra Medical College, Chennai, India.
authors.forename: P K
authors.initials: PK
authors.lastname: Siva Raja
keywords: Fundoplication; Gas bloating syndrome; Laparoscopy; Less blood loss; Less intra operative times; Situs inversus totalis