Laparoscopic cholecystectomy in situs inversus totalis: A case report.

Introduction: Situs inversus totalis (SIT) is a congenital disorder which refers to a mirror image transposition of thoracic and abdominal viscera. Diagnosis and management of cholelithiasis in patient with SIT leads to a challenge due to an underlying anatomical variation. We reported a case of a 50-year-old female patient who presented with an intermit-tent history of epigastric and left upper quadrant pain continued from a month. Clinical assessment and radiological investigations confirmed the presence of cholelithiasis with an evidence of SIT. The patient underwent elective laparoscopic cholecystectomy with no complication and she had an uneventful recovery. Various intraoperative modifications have been made to overcome the technical difficulties encountered due to an underlying anatomical variation. First successful laparoscopic cholecystectomy in patient with SIT performed in 1991. Surgeons managed to get the better of the technical difficulties by embracing adaptable changes in the techniques of conventional laparoscopic cholecystectomy. The anatomical variation in SIT can influence the localization of symptoms in patient with cholelithiasis, which leads to a delay in diagnosis and management. Laparoscopic cholecystectomy can be safely performed in these cases. However, it is considered as a technically challenging procedure and often requires technique to be altered. [ABSTRACT FROM AUTHOR]