Case Report: Laparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis

Background: Situs inversus totalis is inherited as an autosomal recessive trait and occurs in approximately 1 per 10 to 20.000 live births. It’s definite as the transposition of both the thoracic and abdominal viscera to the opposite side of the body. Case Presentation: D.D. was a 42 y old man who experienced 6 months prior of his presentation intermittent nausea,intermittent epigastric pain that radiated laterally to both sides of upper abdomen,shoulder pain and bloating after some meals. He received an abdominal US that showed the presence of gallstones without biliary tree distention, with gallbladder wall thickening. Patient underwent laparoscopic cholecystectomy. The operation was carried out in the usual manner with the trocars placed in locations on the left side of the abdomen as mirror images to their usual location on the right side. On laparoscopic examination the intra-abdominal anatomy was the mirror image of the normal view. Dissection of the triangle Calot and application of the clip and gallbladder dissection was performed by operator’s left hand through the subxiphoid trocar. Conclusions: Some authors suggest that laparoscopic cholecystectomy in patients with left-sided gallbladder is preferred to be performed by left handed surgeons due to better ergonomy; we suggest that surgeon should be right and left handed with experience in laparoscopy and hepatobiliary surgery.