Abstract
The patient was a woman in her twenties who visited our hospital with the chief complaint of epigastralgia. Based on the results of blood tests, ultrasonography and CT, the patient was diagnosed as having cholelithiasis with situs inversus totalis. Considering its cosmetic benefits, we scheduled laparoscopic cholecystectomy via a single incision. In condition of broad base, the operator and the assistant had to position themselves inversely as compared to that for usual laparoscopic cholecystectomy because of the situs inversus totalis. In the upper abdominal region, the organs were positioned symmetrically, therefore, the surgical diagnosis was also situs inversus totalis. The operation was performed by the standard procedure and the operator could freely use both hands. As a result of the anatomical assessments of the blood vessels and biliary tree carried out by imaging examinations preoperatively, we were able to perform the single-incision laparoscopic cholecystectomy safely. In addition to the esthetic outcome, our results suggested that single-incision laparoscopic cholecystectomy might have some advantages in terms of the technical aspects of the surgery in cases of cholelithiasis with situs inversus totalis.
