scholarly journals A Case of Gastric Cancer with Situs Inversus Totalis

2017 ◽  
Vol 10 (1) ◽  
pp. 130-135 ◽  
Author(s):  
Byoung Jo Suh
Keyword(s):  
Gastric Cancer ◽  
Situs Inversus ◽  
Subtotal Gastrectomy ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Surgical Skill ◽  
X Ray ◽  
D2 Lymph Node Dissection ◽  
Positron Emission ◽  
Chest X Ray

Situs inversus totalis (SIT) is a rare congenital anomaly that refers to a completely reversed location of the abdominal and thoracic organs. We report the case of 50-year-old man with gastric cancer and SIT who was diagnosed during a screening esophagogastroduodenoscopy. A chest X-ray, abdominopelvic computed tomography, and 18F-fluoro2-deoxyglucose-D-glucose-positron emission tomography scans revealed SIT. We performed a radical subtotal gastrectomy with D2 lymph node dissection. Advanced surgical skill is required to perform a precise lymphadenectomy in a patient with SIT by visualizing the exact mirror image of the anatomy during the operation. The patient had an uneventful intra- and postoperative course and was followed up at the outpatient department without any evidence of recurrence. In conclusion, surgery in a patient with gastric cancer and SIT can be safely performed by paying attention to the inverted anatomic structures during the operation.

scholarly journals Right Hemihepatectomy via an Anterior Approach for Hepatocellular Carcinoma in a Situs Inversus Totalis Patient

2020 ◽  
Vol 14 (1) ◽  
pp. 91-97
Author(s):  
Rong-Dang Fu ◽  
Jie-Yuan Li ◽  
Xiao-Hong Zhang ◽  
Huan-Wei Chen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Situs Inversus ◽  
Anterior Approach ◽  
Middle Hepatic Vein ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Right Hemihepatectomy ◽  
Glissonian Approach ◽  
Congenital Condition ◽  
Chest X Ray

Situs inversus totalis (SIT) is a rare congenital condition in which the usual position of the organs is reversed from left to right as a mirror image of the normal situation. Due to the abnormal transposition, this represents a technical challenge for the surgeon. In the present study, right hemihepatectomy via the anterior approach was performed for a 68-year-old hepatocellular carcinoma (HCC) patient with SIT. SIT was diagnosed by chest X-ray and computed tomography. The tumors were located in segments VIII and VI of the liver, and there was no metastasis to the lymph nodes and distant organs. Hemihepatic vascular inflow occlusion was performed using the selective intra-Glissonian approach. The middle hepatic vein was preserved under the guidance with intraoperative ultrasonography. The present case suggests that right hemihepatectomy via the anterior approach may be a safe, feasible, and effective procedure for HCC patients with SIT.

scholarly journals Modified laparoscopic cholecystectomy technique for treatment of situs inversus totalis: A case report

2017 ◽  
Vol 45 (3) ◽  
pp. 1261-1267 ◽  
Author(s):  
Jian-jun Ren ◽  
Shu-dong Li ◽  
Ya-jun Geng ◽  
Rui Xiao
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Situs Inversus ◽  
Situs Inversus Totalis ◽  
Chronic Cholecystitis ◽  
Resonance Imaging ◽  
Modified Technique ◽  
X Ray ◽  
Conventional Laparoscopic ◽  
Left Handed ◽  
Chest X Ray

Laparoscopic cholecystectomy is a broadly used technique for gallbladder treatment. However, situs inversus, a rare anomaly, is reportedly difficult to treat by conventional laparoscopic cholecystectomy. A 36-year-old woman with chronic cholecystitis and multiple gallstones was found to have dextrocardia on a chest X-ray. Magnetic resonance imaging demonstrated situs inversus, cholecystitis, and cholelithiasis. We successfully performed laparoscopic cholecystectomy using our modified technique, which mainly involved a left-handed operation and adjustment of the port positions. This case will be very instructive for right-handed surgeons in the management of cholelithiasis by laparoscopic cholecystectomy in patients with situs inversus.

scholarly journals Robotic-assisted proximal gastrectomy using the double-flap technique for early gastric cancer with situs inversus totalis: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Atsushi Takeno ◽  
Toru Masuzawa ◽  
Shinsuke Katsuyama ◽  
Kohei Murakami ◽  
Kenji Kawai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Situs Inversus ◽  
Autosomal Recessive ◽  
Intraoperative Complications ◽  
Proximal Gastrectomy ◽  
Situs Inversus Totalis ◽  
Upper Body ◽  
Robot Assisted ◽  
Case Presentation ◽  
First Case

Abstract Background The robotic system has been applied in the treatment of gastric cancer (GC), and the procedure has been found to be safe and feasible. Situs inversus totalis (SIT) is a relatively rare autosomal recessive congenital anomaly. We successfully performed robot-assisted proximal gastrectomy (RAPG) and handsewn double-flap esophagogastrostomy for GC in a patient with SIT. Case presentation A 71-year-old woman was referred to us with an asymptomatic ulcerative lesion in the upper body of the stomach. Computed tomography revealed that she had SIT. She was diagnosed with cT1bN0M0, cStageIA gastric cancer. RAPG with lymph node dissection and handsewn double-flap esophagogastrostomy was performed. Robotic surgery enabled the surgeon to perform the surgery without changing his position and experiencing any confusion resulting from the patient’s reversed anatomy. It took 448 min, and no intraoperative complications occurred. Her postoperative course was uneventful; she was discharged on postoperative day 10. The final pathologic report showed pT1b1N0M0, pStage IA. Conclusions This is the first case describing RAPG with handsewn double-flap esophagogastrostomy for a SIT patient with early GC.

scholarly journals Endoscopic submucosal dissection of early gastric cancer via inverted overtube in a patient with situs inversus totalis: a case report

2018 ◽  
Vol 06 (05) ◽  
pp. E625-E629
Author(s):  
Youichi Miyaoka ◽  
Shinsuke Suemitsu ◽  
Aya Fujiwara ◽  
Satoshi Kotani ◽  
Kosuke Tsukano ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Situs Inversus ◽  
Gastric Fluid ◽  
Situs Inversus Totalis ◽  
Endoscopic View ◽  
Submucosal Dissection ◽  
The Right ◽  
Lesser Curvature

Abstract Background and study aims A 72-year-old man with complete situs inversus presented with early gastric cancer on the lesser curvature wall of the antrum of the stomach. Endoscopic submucosal dissection (ESD) was selected as a treatment. When the patient was positioned in the left decubitus position, the lesion was hidden by blood and gastric fluid because it was located on the gravitational side. Therefore, we decided to perform ESD with the patient in the right lateral decubitus position and use an inverted overtube, which provided a good endoscopic view without the need to rearrange the endoscopist, assistants, or endoscopic system. ESD was safe and feasible using the inverted overtube.

Situs Inversus Totalis

2001 ◽  
Vol 20 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Janie Spoon
Keyword(s):  
Situs Inversus ◽  
Vena Cava ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
The Body ◽  
Radiographic Examination ◽  
Internal Organs ◽  
Radiographic Findings ◽  
Situs Solitus ◽  
The Right

EXTERNALLY, THE HUMAN BODY appears symmetric; if a line is drawn down the middle of the body, each side appears identical. However, this is not true of the internal anatomy. For example, there is one heart, which lies in the left chest, one liver, in the right abdomen, and one stomach, in the left abdomen. The term situs refers to the position or location of an organ, specifically, the position of the atria and abdominal viscera in relation to the midline of the body.1 There are three types of situs: solitus, inversus, and ambiguous. Situs solitus refers to the normal arrangement of organs, with the right atrium, liver, gallbladder, trilobed lung, and inferior vena cava on the right side and the left atrium, stomach, spleen, bilobed lung, and descending aorta on the left side (Figures 1–3). Situs inversus totalis refers to a mirror image reversal of the normal position of the internal organs (Figures 4 and 5). 1 The incidence of situs inversus totalis is 1 in every 8,000 to 25,000 births, and the condition is most often diagnosed by radiographic examination.2Situs ambiguous, often referred to as heterotaxia, is the random arrangement of the internal organs and is associated with splenic abnormalities and congenital heart disease.3 The purpose of this column is to discuss the embryology, pathophysiology, and diagnosis of situs inversus totalis and to review a case study with radiographic findings.

scholarly journals Laparoscopy-Assisted Distal Gastrectomy for an Early Gastric Cancer Patient With Situs Inversus Totalis

2013 ◽  
Vol 98 (3) ◽  
pp. 266-270 ◽  
Author(s):  
Hirohito Fujikawa ◽  
Takaki Yoshikawa ◽  
Toru Aoyama ◽  
Tsutomu Hayashi ◽  
Haruhiko Cho ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Cancer Patient ◽  
Gastric Cancer Patient ◽  
Situs Inversus ◽  
Distal Gastrectomy ◽  
Operating Time ◽  
Situs Inversus Totalis ◽  
Billroth I ◽  
Billroth I Reconstruction

Abstract Situs inversus totalis (SIT) is a congenital condition in which there is complete right to left reversal of the thoracic and abdominal organs. This report describes laparoscopy-assisted distal gastrectomy (LADG) for an early gastric cancer patient with SIT. The preoperative diagnosis was c-stage IA (cT1a cN0 cH0 cP0 cM0). LADG with D1+ dissection and Billroth-I reconstruction was successfully performed by standing at the opposite position. The operating time was 234 minutes and blood loss was 5 mL. Although a mechanical obstruction occurred after surgery, the patient recovered after re-operation with Roux-en-Y bypass.

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