title: Laparoscopic sigmoidectomy for a patient with situs inversus totalis: effect of changing operator position.
abstract: 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.
authors: 1 Department of Surgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.
authors: Mizunori
authors: M
authors: Yaegashi
authors: Toshimoto
authors: T
authors: Kimura
authors: Takashi
authors: T
authors: Sakamoto
authors: Tadao
authors: T
authors: Sato
authors: Yuichiro
authors: Y
authors: Kawasaki
authors: Koki
authors: K
authors: Otsuka
authors: Go
authors: G
authors: Wakabayashi
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D001706:Biopsy; D003113:Colonoscopy; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D012811:Sigmoid Neoplasms / Q000473:pathology / Q000601:surgery*; D012857:Situs Inversus / Q000150:complications*
keywords: Colon cancer; Laparoscopic sigmoidectomy; Laparoscopic surgery; Situs inversus totalis