Single-port laparoscopic cholecystectomy in situs inversus totalis using the E.K. glove port

Abstract

Laparoscopic cholecystectomy has become the standard treatment for symptomatic cholelithiasis in patients with situs inversus totalis (SIT). In an effort to reduce morbidity and improve the cosmesis single-port laparoscopic cholecystectomy has recently emerged, where the surgery is done through a single port, typically the patient's navel. This improves the cosmesis, lessens post-operative pain and ensures virtually a "scar less" surgery. We report a case of successful single-port laparoscopic cholecystectomy for a patient with SIT, and describe its technical advantages and review of literature.

Keywords: Cholelithiasis; glove port; laparoscopic cholecystectomy; single incision laparoscopic surgery; single port cholecystectomy; situs inversus totalis.

Figure 1

Chest X-Ray Showing dextrocardia

Figure 2

Position of the surgical team and the E.K. Glove port in the umbilicus

Figure 3

Construction of the E.K. Glove port

Figure 4

(a) Intra operative picture showing gall bladder covered with adhesions on left of Ligamentum Teres (b) Ethilon suture used as the fundal retractor (c) Dissection at the Calot's triangle (d) Skin closed with vicryl rapide