Laparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis : Port Placement and Dissection Techniques
BACKGROUND Situs inversus is a rare congenital condition. Since 1991, more than 60 cases of laparoscopic cholecystectomy have been reported in patients with situs inversus. There are many different port placement techniques depending on the surgeon's preference. The fact that some of the critical dissection is easier performed by the left hand poses technical difficulty for right-handed surgeons. CASE REPORT A 56-year-old woman with known situs inversus totalis and extensive past surgical history presented with acute cholecystitis. A Veress needle was used to enter the abdomen at Palmer's point. Visiport was used to place the first 5-mm port at the left mid-clavicular line. The dissection was performed in a mirror image to the usual dissection through the epigastric port. CONCLUSIONS There have been several techniques described in the literature to facilitate the dissection in laparoscopic cholecystectomy in patients with situs inversus totalis. We argue that the first port should be placed at the mid-clavicular line with Visiport. The other ports should be placed in mirror image of the normally placed ports, including a 12-mm epigastric port, 5-mm or 11-mm paraumbilical port, and 5-mm port at the left anterior axillary line. For dissection, we argue that it is preferable to have 2 assistants with 1 retracting the gallbladder and the other holding the camera. This allows the primary surgeon to use the dominant hand during critical dissection in this unfamiliar anatomy.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
|---|---|
| Enthalten in: |
The American journal of case reports - 21(2020) vom: 04. Sept., Seite e924896 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Du, Tianli [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 14.05.2021 Date Revised 14.05.2021 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.12659/AJCR.924896 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM314594787 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM314594787 | ||
| 003 | DE-627 | ||
| 005 | 20231225153050.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.12659/AJCR.924896 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1048.xml |
| 035 | |a (DE-627)NLM314594787 | ||
| 035 | |a (NLM)32886654 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Du, Tianli |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Laparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis |b Port Placement and Dissection Techniques |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.05.2021 | ||
| 500 | |a Date Revised 14.05.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND Situs inversus is a rare congenital condition. Since 1991, more than 60 cases of laparoscopic cholecystectomy have been reported in patients with situs inversus. There are many different port placement techniques depending on the surgeon's preference. The fact that some of the critical dissection is easier performed by the left hand poses technical difficulty for right-handed surgeons. CASE REPORT A 56-year-old woman with known situs inversus totalis and extensive past surgical history presented with acute cholecystitis. A Veress needle was used to enter the abdomen at Palmer's point. Visiport was used to place the first 5-mm port at the left mid-clavicular line. The dissection was performed in a mirror image to the usual dissection through the epigastric port. CONCLUSIONS There have been several techniques described in the literature to facilitate the dissection in laparoscopic cholecystectomy in patients with situs inversus totalis. We argue that the first port should be placed at the mid-clavicular line with Visiport. The other ports should be placed in mirror image of the normally placed ports, including a 12-mm epigastric port, 5-mm or 11-mm paraumbilical port, and 5-mm port at the left anterior axillary line. For dissection, we argue that it is preferable to have 2 assistants with 1 retracting the gallbladder and the other holding the camera. This allows the primary surgeon to use the dominant hand during critical dissection in this unfamiliar anatomy | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Hawasli, Abdelkader |e verfasserin |4 aut | |
| 700 | 1 | |a Summe, Karen |e verfasserin |4 aut | |
| 700 | 1 | |a Meguid, Ahmed A |e verfasserin |4 aut | |
| 700 | 1 | |a Lai, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Sadoun, Moutamn |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The American journal of case reports |d 2009 |g 21(2020) vom: 04. Sept., Seite e924896 |w (DE-627)NLM226518345 |x 1941-5923 |7 nnns |
| 773 | 1 | 8 | |g volume:21 |g year:2020 |g day:04 |g month:09 |g pages:e924896 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.12659/AJCR.924896 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 21 |j 2020 |b 04 |c 09 |h e924896 | ||