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Reduced-Port Laparoscopic Surgery for Patients With Proximal Transverse Colon Cancer With Situs Inversus Totalis: A Case Report.

ABSTRACT: Situs inversus is a rare hereditary disorder in which various anomalies have been reported with internal rotation abnormalities. This case involved an 85-year-old woman who had been diagnosed with transverse colon cancer and who underwent reduced-port laparoscopic surgery. All intra-abdominal organs were reversed left to right and right to left. The aberrant midcolic artery was identified during surgery. The total surgery time was 170 minutes, and the patient lost 20 mL of blood. The patient was discharged on the 8th postoperative day without complications.

SUBMITTER: Yeom SS

PROVIDER: S-EPMC6347341 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Reduced-Port Laparoscopic Surgery for Patients With Proximal Transverse Colon Cancer With Situs Inversus Totalis: A Case Report.

Yeom Seung-Seop SS Kim Kyung Hwan KH Lee Soo Young SY Kim Chang Hyun CH Kim Hyeong Rok HR Kim Young Jin YJ

Annals of coloproctology 20181231 6

Situs inversus is a rare hereditary disorder in which various anomalies have been reported with internal rotation abnormalities. This case involved an 85-year-old woman who had been diagnosed with transverse colon cancer and who underwent reduced-port laparoscopic surgery. All intra-abdominal organs were reversed left to right and right to left. The aberrant midcolic artery was identified during surgery. The total surgery time was 170 minutes, and the patient lost 20 mL of blood. The patient was ...[more]

PMID: 30630305

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Usefulness of an intraoperative flipped monitor in laparoscopic surgery with situs inversus totalis: a case report of laparoscopic-assisted ileocecal resection.

Project description:BackgroundSitus inversus totalis (SIT) is a rare congenital condition that involves complete transposition (right to left reversal) of the visceral organs. Laparoscopic surgery can be challenging because of the mirror-image anatomy. We describe a surgical innovation in laparoscopic surgery for SIT.Case presentationA 41-year-old man with SIT was diagnosed with an appendiceal tumor and underwent laparoscopic-assisted ileocecal resection. Preoperatively, we evaluated anatomical variations using 3D-computed tomography and simulated mirror images by watching flipped videos of patients with normal anatomy undergoing similar operations. During the operation, port placement and the surgeons' standing positions were reversed. Additionally, two monitors were placed at the patient's head, with one monitor showing original images, and the other showing flipped images that looked the same as the normal anatomy. We checked the range of the mobilized region and important anatomical structures by watching the flipped monitor as needed. The patient's postoperative course was uneventful.ConclusionsDue to the complexities of laparoscopic surgery for SIT, preoperative preparation and surgical innovation are necessary for safe surgery. Several suggestions have been made to understand anatomical anomalies and improve operability; however, surgeons must focus on the mirror-image anatomy throughout the operation. Therefore, the use of intraoperative flipped monitor will be helpful for surgeons in reducing the risk of anatomical misidentification.

| S-EPMC10774461 | biostudies-literature

Laparoscopic biliopancreatic diversion for a morbidly obese patient with situs inversus totalis: Case report.

Project description:INTRODUCTION:Situs inversus is a rare congenital anomlay in which the thoracic and abdominal organs are sited on the opposite side to that of normal anatomy. Its etiology is still unknown. It is classified into situs inversus partialis and situs inversus totalis. It is discovered incidentally in most cases. Any surgical intervention for such patients may encounter intra-operative technical difficulties due to anatomical differences, particularly if a laparoscopic approach is adopted, as in bariatric surgeries where the obesity itself opposes an added surgical challenge. CASE PRESENTATION:A female patient with a BMI of 52.1?Kg/m2 was being prepared for biliopancreatic diversion. She was diagnosed incidentally as having situs inversus totalis during the preoperative evaluation. She underwent an uneventful laparoscopic biliopancreatic diversion. She was followed up regularly in the bariatric surgery clinic for 9 years. Her last BMI was 29?Kg /m2 with no signs or symptoms of metabolic complications. CONCLUSION:This case report demonstrates that biliopancreatic diversion can be done safely in morbidly obese patients with situs inversus by an experienced bariatric surgeon in a specialized well-equipped center.

| S-EPMC6047057 | biostudies-literature

Biliary stone in patient with situs inversus totalis.

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| S-EPMC11332169 | biostudies-literature

Partial sternotomy coronary surgery with triple-vessel disease in dextrocardia and situs inversus totalis.

Project description:Dextrocardia associated with situs inversus totalis is a rare congenital condition. A small number of cases with these conditions have been reported who underwent myocardial revascularization via the on-pump or off-pump techniques. Among them, only 1 patient with dextrocardia and situs inversus totalis was reported to have the procedure performed with minimally invasive coronary surgery via a right anterior small thoracotomy. However, the case was a single-vessel disease and only one graft was achieved. We describe the case of a 65-year old female patient with triple-vessel obstructive coronary diseases who was successfully revascularized with three grafts using a minimally invasive technique. This was achieved via partial sternotomy and employing off-pump coronary artery bypass grafting.

| S-EPMC3686400 | biostudies-literature

Laparoscopic cholecystectomy for left-sided gall bladder in situs inversus totalis patient, a technically demanding procedure.

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| S-EPMC6804321 | biostudies-literature

Laparoscopic sleeve gastrectomy in a patient with Situs Inversus Totalis: A case report and literature review.

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| S-EPMC9289484 | biostudies-literature

A Homozygous Nme7 Mutation Is Associated with Situs Inversus Totalis.

Project description:We investigated the cause of situs inversus totalis (SIT) in two siblings from a consanguineous family. Genotyping and whole-exome analysis revealed a homozygous change in NME7, resulting in deletion of an exon causing an in-frame deletion of 34 amino acids located in the second NDK domain of the protein and segregated with the defective lateralization in the family. NME7 is an important developmental gene, and NME7 protein is a component of the ?-tubulin ring complex. This mutation is predicted to affect the interaction of NME7 protein with this complex as it deletes the amino acids crucial for the binding. SIT associated with homozygous deletion in our patients is in line with Nme7(-/-) mutant mice phenotypes consisting of congenital hydrocephalus and SIT, indicating a novel human laterality patterning role for NME7. Further cases are required to elaborate the full human phenotype associated with NME7 mutations.

| S-EPMC6066188 | biostudies-literature

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Project description:Situs inversus totalis is a rare condition where the visceral organs are organized as a mirror image of default organ position. In this study we picture the co-development between brain and visceral organs in a case of situs inversus totalis from a fetal stage to adolescence and compare our findings to an age-, gender-, and education-matched control with normal position of thoracic and abdominal organs. We show that in this case of situs inversus, functional and structural brain lateralization do not coincide with visceral organ situs. Furthermore, cognitive development in situs inversus is normal. To our knowledge, this is the first report of antenatal cerebral origins of structural and functional brain asymmetry in a case of situs inversus totalis.

| S-EPMC6192509 | biostudies-literature

Laparoscopic cholecystectomy in a patient with situs inversus totalis: case report with review of literature.

Project description:Situs inversus totalis is a rare autosomal recessive disorder which can cause diagnostic confusion in a lot of clinical conditions including calculous cholecystitis due to the reversed anatomical positions of abdominal viscera. Laparoscopic cholecystectomy is much more challenging in the presence of this disorder due to loss of usual orientation. We present a case of a 43-year-old woman who was diagnosed at our centre to have calculous cholecystitis in the presence of situs inversus totalis. Laparoscopic cholecystectomy was performed safely after adjustment of the positions of the team inside the operative theatre and of the port sites. The patient tolerated the operation very well and was discharged home after 24h. On follow-up visit the patient was doing very well and completely free of symptoms.

| S-EPMC3822187 | biostudies-other

Laterality defects other than situs inversus totalis in primary ciliary dyskinesia: insights into situs ambiguus and heterotaxy.

Project description:Motile cilia dysfunction causes primary ciliary dyskinesia (PCD), situs inversus totalis (SI), and a spectrum of laterality defects, yet the prevalence of laterality defects other than SI in PCD has not been prospectively studied.In this prospective study, participants with suspected PCD were referred to our multisite consortium. We measured nasal nitric oxide (nNO) level, examined cilia with electron microscopy, and analyzed PCD-causing gene mutations. Situs was classified as (1) situs solitus (SS), (2) SI, or (3) situs ambiguus (SA), including heterotaxy. Participants with hallmark electron microscopic defects, biallelic gene mutations, or both were considered to have classic PCD.Of 767 participants (median age, 8.1 years, range, 0.1-58 years), classic PCD was defined in 305, including 143 (46.9%), 125 (41.0%), and 37 (12.1%) with SS, SI, and SA, respectively. A spectrum of laterality defects was identified with classic PCD, including 2.6% and 2.3% with SA plus complex or simple cardiac defects, respectively; 4.6% with SA but no cardiac defect; and 2.6% with an isolated possible laterality defect. Participants with SA and classic PCD had a higher prevalence of PCD-associated respiratory symptoms vs SA control participants (year-round wet cough, P < .001; year-round nasal congestion, P = .015; neonatal respiratory distress, P = .009; digital clubbing, P = .021) and lower nNO levels (median, 12 nL/min vs 252 nL/min; P < .001).At least 12.1% of patients with classic PCD have SA and laterality defects ranging from classic heterotaxy to subtle laterality defects. Specific clinical features of PCD and low nNO levels help to identify PCD in patients with laterality defects.ClinicalTrials.gov; No.: NCT00323167; URL: www.clinicaltrials.gov.

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