Abstract
We report a case of laparoscopic cholecystectomy in a patient with situs inversus totalis. A 65-year-old man was admitted to hospital because of symptomatic multiple gallstones. Abdominal ultrasonography and computed tomography (CT) confirmed the diagnosis of cholecystolithiasis, as well as situs inversus totalis with the liver and the gallbladder located on the left side. Three dimensional CT did not visualize the gallbladder. A cholecystectomy was performed laproscopically. A 12-mm trocar was inserted through an infra-umbilical incision. Two 5-mm trocars were placed in the upper midline and the left anterior axillary line, respectively. A 12-mm trocar was inserted 7 cm below in the left subcostal midclavicular line to maintain an appropriate distance from the upper midline trocar. The laparoscopic cholecystectomy was carried out without any complications. The postoperative course was uneventful, and the patient was discharged on the second postoperative day. A double-handed technique, in particular involving left-hand manipulation is crucial when doing a laparoscopic cholecystectomy in a patient with situs inversus totalis.
