Laparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis: Feasibility and Technical Difficulties

BACKGROUND Laparoscopic cholecystectomy is one of the most frequently performed surgical procedures by the general surgeon. This situation allows determining a defined surgical strategy in most patients. However, some factors may induce modification by the surgical team. Our objectives were to describe and analyze the variation of the surgical technique used during laparoscopic cholecystectomy in a female patient with situs inversus totalis. CLINICAL CASE We report the case of a 70-year-old female with a diagnosis of chronic gallstone cholecystitis and situs inversus totalis. Modifications in the surgical technique are detailed, and anatomic variations of the intraabdominal organs are described. Postoperative evolution was satisfactory and the patient was highly satisfied with the surgical outcome. There was no associated morbidity. CONCLUSIONS Variations in intraabdominal anatomy, alteration of cystic artery location and changes in position of the abdominal ports prompted us to modify the standard surgical technique for laparoscopic cholecystectomy. However, these factors did not alter results or the patient's postoperative evolution.