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2009, Number 2

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Cir Cir 2009; 77 (2)

Technical considerations during laparoscopic cholecystectomy in a patient with situs inversus totalis

Pereira-Graterol F, Siso-Calderón L

Language: Spanish
References: 20
Page: 145-148
PDF size: 195.81 Kb.


ABSTRACT

Background: Laparoscopic cholecystectomy is one of the most frequently performed surgical procedures by the general surgeon. This situation allows determining a defined surgical strategy in most patients. However, some factors may induce the surgical team to modify it. Our objectives were to describe and analyze the variation of the surgical technique used during laparoscopic cholecystectomy in a female patient with situs inversus totalis.
Clinical case: We report the case of a 70-year-old female with diagnosis of chronic gallstone cholecystitis and situs inversus totalis. Modifications in the surgical technique are detailed, and the anatomic variations of the intraabdominal organs are described. Postoperative evolution was satisfactory and the patient was highly satisfied with the surgical outcome. There was no associated morbidity.
Conclusions: Intraabdominal anatomic variations, alteration of cystic artery location and changes in the position of the abdominal ports induced us to modify the standard surgical technique for laparoscopic cholecystectomy; nevertheless, these factors did not alter the result or postoperative evolution of the patient.


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