Syeda Kisa Fatima Zaidi, Amna Saleem, Rehan Ahmed, Muhammad Sarfraz Ahmed.
Laparoscopic Cholesystectomy in situs inversus totalis.
Pak J Surg Jan ;37(4):311-4.

Introduction: Situs Inversustotalis, a rare genetic condition which involves complete transposition of abdominal and thoracic organs. A 30 year old female with situs inversus totalis (SIT) presented with cholelithiasis. Surgical approach to left sided liver is difficult and involves meticulous dissection by experienced hands to safely remove gallbladder. The abdominothoracic organs in such a case are a mirror image of the normal, so identification and dissection of calot`s triangle can be challenging. Moreover, right-sided approach for a left-sided liver involves re-orientation of operative staff along with the surgical setup leading to increased operative duration. Conclusion: Experienced and skilled surgeons are required to operate on a patient with reversed anatomy to prevent any iatrogenic injury. Review of surgical techniques might be required. Full pre-operative evaluation of such a patient must be carried out as there are risks of congenital cardiac and respiratory issues in patients with situs inversustotalis.

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