Publication: Laparoscopic Cholecystectomy in Situs Inversus Totalis with Stage 5 Chronic Kidney Disease: A Case Report
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Medical Association
Abstract
Abstract
Situs inversus totalis is a rare congenital anomaly in which the abdominal and thoracic organs are
transposed in a mirror image. Diagnosis and management of cholelithiasis in patients with situs
inversus totalis pose a challenge due to the anatomical variation. A laparoscopic cholecystectomy in such a case can be technically challenging, especially for a right-handed surgeon. In this case report, we present a case of a 38-year-old male with symptomatic cholelithiasis in a chronic kidney disease stage five patient under maintenance hemodialysis planned for recipient renal transplant. A laparoscopic cholecystectomy considered the gold standard for symptomatic cholelithiasis was performed with a three-port technique. The technical challenges anticipated due to anatomical variation were managed by intraoperative modifications. In conclusion, laparoscopic cholecystectomy in patients with situs inversus totalis can be done with technical modifications and re-orientation of visual motor skills.
Description
Sneha Raut
Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
Yugal Limbu
Department of Gastro- intestinal and General Surgery, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
Prashanta Pudasaini
Department of Gastro-intestinal and General Surgery, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
Swagat Gongal
Department of Anesthesiology, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
Dhiresh Kumar Maharjan
Department of Gastro-intestinal and General Surgery, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal