Single-port Cholecystectomy in a Patient with Situs Inversus Totalis Presenting With Cholelithiasis

A Case Report

Marcus VD de Campos Martins; José L Pantaleão Falcão; James Skinovsky; Guilherme MSS de Faria


J Med Case Reports. 2012;6(96) 

In This Article

Case Presentation

A 59-year-old African woman presented to our surgical clinic with a few months history of intermittent left upper quadrant pain aggravated by fatty food. Imaging via an ultrasound scan showed abdominal situs inversus with gallstones in a left-sided gallbladder. A pre-operative chest X-ray showed dextrocardia with situs inversus with no evidence of bronchiectasis.

A single-port cholecystectomy was performed using a SITRACC device (Figure 1). Our patient was placed in the supine position with both the surgeon and camera operator on his right side and the assistant on the left side. The monitor was placed near our patient's head at the left side. The SITRACC device was placed using an open technique. A flexible grasper retracted the gallbladder (Figure 2). A Calot dissection was performed using a left-hand grasper and hook. Clips were applied to both cystic artery and duct. The gallbladder dissection from the liver was uneventful. The specimen was delivered through the umbilicus and the fascia and skin were closed (Figure 3). Our patient had an uneventful post-operative course and was discharged on the second post-operative day.

Figure 1.

The single trocar access device (SITRACC).

Figure 2.

Gallbladder retraction.

Figure 3.

Single-port incision closed.