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

Abstract and Introduction


Introduction Situs inversus totalis (mirror image organs) is a rare condition and may affect the intra-abdominal viscera as well as the intrathoracic organs. Cholelithiasis is not more common in these conditions, but the diagnosis may be more difficult.
Case presentation We present the case of a 59-year-old African woman with gallstones and situs inversus totalis. A single-port cholecystectomy was performed using a single trocar access device (SITRACC).
Conclusions The procedure was uneventful, showing that this approach may be an option for this kind of surgery even in patients with situs inversus totalis.


Situs inversus totalis (SIT; the 'mirror image' reversal of major organs) is a rare congenital abnormality that affects approximately 0.005% of all live births.[1] There have been several reports of laparoscopic cholecystectomy for cholelithiasis in situs inversus totalis, none of them using a single-port device.[2–6]

Our group has been working on the development of single-port platforms and natural orifices surgeries since 2006.[7] We published our first experimental study in 2008[8] and the Anvisa (Brazilian National Health Surveillance Agency) approved this device, called SITRACC (for "single trocar access'), for human use in 2009. In the same year we coordinated and published a multicenter study of SITRACC cholecystectomies that included 81 cases.[9]

A comprehensive search of the PubMed, Scielo and Embase databases was performed in August of 2011 using medical subject headings 'cholecystectomy', 'cholecystectomy, laparoscopic' and 'situs inversus'. There is a published report on single-incision multiport laparoscopic cholecystectomy for a patient with situs inversus totalis,[10] but there is no data published regarding a single-port technique.


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