title: Laparoscopic-assisted total gastrectomy for early gastric cancer with situs inversus totalis: report of a first case.
abstract: BACKGROUND
  Situs inversus totalis is a relatively rare condition and is an autosomal recessive congenital defect in which an abdominal and/or thoracic organ is positioned as a "mirror image" of the normal position in the sagittal plane. We report our experience of laparoscopic-assisted total gastrectomy with lymph node dissection performed for gastric cancer in a patient with situs inversus totalis.
  
  
  METHODS
  A 58-year-old male was diagnosed with cT1bN0N0 gastric cancer. There were no vascular anomalies on abdominal angiographic computed tomography with three-dimensional reconstruction. laparoscopic-assisted total gastrectomy was performed with D1+ lymph node dissection, in accordance with the Japanese Gastric Cancer Treatment Guidelines. There were no intraoperative issues, and no postoperative complications.
  
  
  CONCLUSIONS
  This was the first report describing laparoscopic-assisted total gastrectomy with the standard typical lymph node dissection in the English literature. We emphasize that the position of trocars and the standing side of the primary surgeon during the lymph node dissection are critical.
authors.affiliation: Department of Surgery, Kariya Toyota General Hospital, Kariya, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Morimoto
authors.affiliation: Department of Surgery, Kariya Toyota General Hospital, Kariya, Japan.
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Hayakawa
authors.affiliation: Department of Surgery, Kariya Toyota General Hospital, Kariya, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Kitagami
authors.affiliation: Department of Surgery, Kariya Toyota General Hospital, Kariya, Japan.
authors.forename: Moritsugu
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuhoku, Nagoya, 467-8601, Japan. matsuo@med.nagoya-cu.ac.jp.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuhoku, Nagoya, 467-8601, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Takeyama
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery*; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012857:Situs Inversus / Q000150:complications*; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*