Abstract
A 76-year-old woman with situs inversus totalis had an slightly elevated early gastric cancer with 4 cm in size the posterior wall of the lesser curvature in the upper gastric body. Initial endoscopic examination performed in the left lateral decubitus position, gastric contents, A endoscopic examination in the left decubitus position the gross morphology of the lesion, but detailed observation of superficial structures were hampered by gastroesophugeal reflux. Although the patient was re-scoped in the right lateral decubitus position, the examination couldn't be completed due to technical difficulties. According to the therapeutic guidelines for gastric cancer in Japan, endoscopic resection was applied to this gastric lesion. Considering the past two endoscopic examinations, ESD was performed in the left lateral decubitus position. Consequently, the gastric cancer was successfully resected without any complication, and pathologically curable resection was achieved in accordance with the therapeutic guidelines.
