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解剖学挑战中的适应性:一例全内脏反位患者的腹腔镜胆囊切除术

Adaptability in the Midst of Anatomical Challenges: A Case of Situs Inversus Totalis in Laparoscopic Cholecystectomy.

作者信息

Nguyen Christopher, Schutter David

机构信息

Medicine, Lincoln Memorial University, DeBusk College of Osteopathic Medicine, Knoxville, USA.

General Surgery, Premier Surgical, Knoxville, USA.

出版信息

Cureus. 2024 Apr 22;16(4):e58770. doi: 10.7759/cureus.58770. eCollection 2024 Apr.

Abstract

Situs inversus totalis (SIT) is a rare and nonfatal congenital anomaly where there is a complete inversion of a patient's visceral organs. Throughout the patient's lifetime, they will encounter various challenges due to their unique anatomic variation. In this case, we report the treatment of symptomatic cholelithiasis in a 33-year-old female with comorbid SIT who underwent a laparoscopic cholecystectomy without postoperative complications. Despite the added layer of complexity in her presentation, we were able to perform the cholecystectomy laparoscopically with slight modifications to better accommodate her anatomical mirroring. Modifications made in the form of bed positioning, trochar placement, and surgical team positioning prove that strategic operative planning is essential to optimizing outcomes for this unique patient population.

摘要

全内脏反位(SIT)是一种罕见的非致命性先天性异常,患者的内脏器官完全反转。在患者的一生中,由于其独特的解剖变异,他们将面临各种挑战。在此病例中,我们报告了一名33岁患有SIT合并症的女性有症状胆结石的治疗情况,该患者接受了腹腔镜胆囊切除术,术后无并发症。尽管她的病情增加了复杂性,但我们能够通过轻微调整以更好地适应其解剖镜像,从而进行腹腔镜胆囊切除术。通过调整床位、套管针放置位置和手术团队位置等方式进行的调整证明,战略性手术规划对于优化这类特殊患者群体的治疗效果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7dc/11111283/2671c0d1f854/cureus-0016-00000058770-i01.jpg

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