Three port laparoscopic cholecystectomy in situs inversus totalis: A case report

Situs inversus totalis (SIT) is a rare anomaly characterized by transposition of organs to the opposite side of the body in a mirror image of normal anatomy. Location of symptoms and signs arising from a diseased organ may vary. The diagnosis as well as to operate any pathology in such patient is difficult. Laparoscopic cholecystectomy in patient with situs inversus totalis is a challenge but not a contraindication. We have reported here case of an adult woman who presented with on and off pain located at the epigastrium. Clinical examination and laboratory investigations were unremarkable. During radiological evaluation, the patient was found to have situs inversus totalis and features of chronic cholecystitis with cholelithiasis. Laparoscopic cholecystectomy was safely performed with the three-port technique in a reverse fashion by right handed surgeon. In conclusion, Laparoscopic cholecystectomy in these patients is technically more demanding and needs reorientation of visual-motor skills.