Laparoscopic sigmoidectomy in a case of sigmoid colon cancer with situs inversus totalis.

Situs inversus totalis (SIT) is a rare anatomic anomaly in which organs in the chest and abdomen exist in a mirror image reversal of their normal positions. SIT can complicate surgical procedures, and few reports have described laparoscopic surgery for colorectal cancer in patients with SIT. Here, we report a case of successful laparoscopic surgery in a patient with SIT and sigmoid colon cancer. Laparoscopic sigmoidectomy involved colonic mobilization with high ligation of the inferior mesenteric vessels and complete mesocolic excision. The operating surgeon stood on the patient's left side, opposite the normal location for sigmoidectomy. By placing a 12-mm trocar in the left iliac fossa and using an automatic endoscopic linear stapler, the operating surgeon was able to perform left-handed colon resection without having to change position or move the laparoscopic monitor mid-procedure. An automatic endoscopic linear stapler is useful for laparoscopic left-side colon surgery in a patient with SIT.