Laparoscopic cholecystectomy in situs inversus totalis

Abstract

Situs Inversus Totalis is a rare genetic disorder characterized by the transposition of the thoracoabdominal organs in a sagittal direction, providing a so-called “mirror” image. Its etiology is not yet clear, but it is believed to be due to a genetic predisposition due to an autosomal recessive incomplete penetrance gene. The presence of symptomatic gallstones in a patient with situs inversus totalis leads not only to diagnostic doubts, but also constitutes a real therapeutic challenge, since any surgical procedure is technically more difficult in these patients (especially laparoscopic cholecystectomy) due to the anatomical abnormalities they present. We present the case of a 61-year-old female patient who came to the service of our hospital for abdominal pain and who was diagnosed with gallstones in situs inversus abdominal, performing imaging studies that confirmed the diagnosis of situs inversus totalis. Laparoscopic cholecystectomy was performed with the same standards of conventional laparoscopic cholecystectomy, observing the same results as in patients with Situs Solitus.