title: Laparoscopic sleeve gastrectomy with duodeno-jejunal bypass for morbid obesity in a patient with situs inversus totalis.
abstract: Laparoscopic sleeve gastrectomy with duodeno-jejunal bypass (LSG/DJB) has been adopted in our center for the treatment of morbidly obese patients with both severe type 2 diabetes mellitus and existing risks factors for gastric cancer. We have successfully performed over 200 LSG/DJB procedures in our institution. Here we report the techniques used to perform LSG/DJB in a morbidly obese patient with situs inversus totalis. The only significant difference in executing LSG/DJB between normal anatomy and situs inversus totalis is changing the surgeon's position and switching the trocar placements during the intraoperative phase. Consequently, there were no significant difference in operative time between normal anatomy cases and the situs inversus totalis case.
authors.affiliation: Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Seki
authors.affiliation: Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kasama
mesh_terms: D000714:Anastomosis, Surgical; D050110:Bariatric Surgery / Q000379:methods*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D012857:Situs Inversus / Q000150:complications*
keywords: laparoscopic sleeve with duodeno-jejunal bypass; morbid obesity; situs inversus totalis