Cunningham Brian, Blades Daryl, McArdle Gerade
Northern Ireland Medical and Dental Training Agency, Belfast, BT8 7RL, United Kingdom.
Southern Health and Social Care Trust, Department of General Surgery, Portadown, BT63 5QQ, United Kingdom.
J Surg Case Rep. 2024 Jul 13;2024(7):rjae450. doi: 10.1093/jscr/rjae450. eCollection 2024 Jul.
Situs inversus totalis (SIT) is a rare congenital condition in which there is complete transposition of both the thoracic and abdominal viscera. Given how infrequently this abnormality is encountered, operating on patients with SIT can be technically difficult and challenging for the surgeon. This case report outlines the steps used to successfully carry out a laparoscopic cholecystectomy on a patient with SIT. The aim of this report is to highlight the technical difficulties encountered during this common surgical procedure. By sharing our operative experience, we hope to assist operating surgeons in their perioperative planning when faced with a similar case. Our approach to port placement, dissection of Calot's triangle, and achieving adequate tissue tension is discussed. Ultimately, we believe that advanced planning, anticipation of likely challenges, and knowledge of strategies to overcome these can only be beneficial to the safety of performing laparoscopic cholecystectomy in a patient with SIT.
全内脏转位(SIT)是一种罕见的先天性疾病,其中胸腔和腹腔内脏器完全转位。鉴于这种异常情况很少见,对SIT患者进行手术对外科医生来说在技术上可能困难且具有挑战性。本病例报告概述了对一名SIT患者成功实施腹腔镜胆囊切除术所采用的步骤。本报告的目的是突出在这种常见外科手术过程中遇到的技术难题。通过分享我们的手术经验,我们希望在面临类似病例时,能帮助外科手术医生进行围手术期规划。我们讨论了端口放置、胆囊三角解剖以及实现足够组织张力的方法。最终,我们认为提前规划、对可能挑战的预判以及克服这些挑战的策略知识,只会有利于对SIT患者进行腹腔镜胆囊切除术的安全性。