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Case Reports
. 2022 Jan;15(1):168-171.
doi: 10.1111/ases.12944. Epub 2021 Apr 23.

Laparoscopic sigmoidectomy with splenic flexure mobilization for colon cancer in situs inversus totalis: Preoperative assessment and preparation

Takuya Kudo  1 , Takeru Matsuda  1   2 , Naoki Urakawa  1 , Hiroshi Hasegawa  1 , Shingo Kanaji  1 , Kimihiro Yamashita  1 , Taro Oshikiri  1 , Yoshihiro Kakeji  1
Affiliations
Case Reports

Laparoscopic sigmoidectomy with splenic flexure mobilization for colon cancer in situs inversus totalis: Preoperative assessment and preparation

Takuya Kudo et al. Asian J Endosc Surg. 2022 Jan.

Abstract

Situs inversus totalis (SIT) is a rare condition in which the internal organ's position is a mirror image of normal anatomy. Although several investigators reported laparoscopic surgery for colorectal cancer in patients with SIT, it is considered difficult even for an experienced surgeon because of the mirror position. We show a case report of laparoscopic sigmoidectomy with the splenic flexure mobilization (SFM) procedure in SIT. A 79-year-old woman with SIT was referred to our hospital for a locally advanced sigmoid cancer (cT3N1M0, cStageIIIB). We safely performed the laparoscopic sigmoidectomy with SFM, as shown in detail below. No postoperative complication occurred, and the patient is in good health with no recurrences 30 months after surgery, as of the writing this report. We propose three critical points; checking the CT angiography to understand the anatomy; using flip-horizontal video of "normal" laparoscopic sigmoidectomy to confirm an unfamiliar situation; adding the epigastric trocar to make SFM procedures safe and comfortable.

Keywords: colon cancer; laparoscopic sigmoidectomy; situs inversus totalis.

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References

REFERENCES

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