Langenbeck's Archives of Surgery

, Volume 389, Issue 5, pp 396–399 | Cite as

Laparoscopic surgery in situs inversus: a literature review and a report of laparoscopic sigmoidectomy for diverticulitis in situs inversus

  • Christian Kobus
  • Eduardo M. Targarona
  • Galit Even Bendahan
  • Verónica Alonso
  • Carmen Balagué
  • Sandra Vela
  • Jordi Garriga
  • Manuel Trias
Original Article



Situs inversus (SI) is a rare autosomal recessive congenital defect in which the position of abdominal and/or thoracic organs is a “mirror image” of the normal one, in the sagittal plain. In 25% of these cases, SI is part of the Kartagener syndrome, together with bronchiectasis and chronic sinusitis.


We present a case of a patient with Kartagener syndrome and complete SI that was laparoscopically operated on for diverticulitis. We also review the published English information available on this rare condition.


A review of the literature revealed another single case of laparoscopic sigmoidectomy and 27 cases of other laparoscopic interventions in the presence of SI. Those laparoscopic procedures included basic procedures such as explorations and cholecystectomies, as well as advanced procedures such as gastrectomy and gastric bypass.


The laparoscopic approach is feasible in cases of SI, although technically more complicated because of the different position of the organs and the different laparoscopic view of the anatomy.


Laparoscopic colectomy Situs inversus Diverticulitis 


  1. 1.
    Douard R, Feldman A, Bargy F, Loric S, Delmas V (2000) Anomalies of lateralization in man: a case of total situs inversus. Surg Radiol Anat 22:293–297PubMedGoogle Scholar
  2. 2.
    Davies H, Slater GH, Bailey M (2002) Laparoscopic sigmoid colectomy for diverticular disease in a patient with situs inversus. Surg Endosc 17:160–161Google Scholar
  3. 3.
    Yamaguchi S, Orita T, Mii S, Sakata H, Hashizume M (2002) Laparoscope-assisted distal gastrectomy for early gastric cancer in a 76 year-old man with situs inversus totalis. Surg Endosc 17:352–353Google Scholar
  4. 4.
    Polychronidis A, Karayiannakisa, Botaitis S, Perente S, Simopoulos C (2002) Laparoscopic cholecystectomy in a patient with situs inversus totalis and previous abdominal surgery. Surg Endosc 16:1110CrossRefGoogle Scholar
  5. 5.
    Nursal TZ, Baykal A, Iret D, Aran O (2001) Laparoscopic cholecystectomy in a patient with situs inversus totalis. J Laparoendosc Adv Surg Tech A 11:239–241CrossRefPubMedGoogle Scholar
  6. 6.
    Yaghan RJ, Gharaibeh KI, Hammori S (2001) Feasibility of laparoscopic cholecystectomy in situs inversus. J Laparoendosc Adv Surg Tech A 11:233–237CrossRefPubMedGoogle Scholar
  7. 7.
    Al-Jumaily M, Hoche F (2001) Laparoscopic cholecystectomy in situs inversus totalis: is it safe? J Laparoendosc Adv Surg Tech A 11:229–231CrossRefPubMedGoogle Scholar
  8. 8.
    Donthi R, Thomas DJ, Sanders D, Schmidt SP (2001) Report of laparoscopic cholecystectomy in two patients with left-sided gallbladders. J Soc Laparoendosc Surg 5:53–56Google Scholar
  9. 9.
    Demetriades H, Botsios D, Dervenis C, Evagelou J, Agelopoulos S, Dadoukis J (1999) Laparoscopic cholecystectomy in two patients with symptomatic cholelithiasis and situs inversus totalis. Dig Surg 16:519–521CrossRefPubMedGoogle Scholar
  10. 10.
    D’Agata A, Boncompagni G (1997) Video laparoscopic cholecystectomy in situ viscerum inversus totalis. Minerva Chir 52:271–275PubMedGoogle Scholar
  11. 11.
    Crosher RF, Harnarayan P, Bremner DN (1996) Laparoscopic cholecystectomy in situs inversus totalis. J R Coll Surg Edinb 41:183–184PubMedGoogle Scholar
  12. 12.
    Elhomsy G, Matta W, Varaei K, Garcet L, Rahmani M (1996) The millepede and the surgeon. Apropos of lap. Cholecystectomy in a case of situs inversus or automatic gesture constricted by reason. J Chir (Paris) 133:43Google Scholar
  13. 13.
    Schiffino L, Mouro J, Levard H, Dubois F (1993) Cholecystectomy via laparoscopy in situs inversus totalis. A case report and review of the literature. Minerva Chir 48:1019–1023PubMedGoogle Scholar
  14. 14.
    Huang SM, Chau GY, Lui WY (1992) Laparoscopic cholecystectomy for cholelithiasis in a patient with situs inversus totalis. Endoscopy 24:802–803PubMedGoogle Scholar
  15. 15.
    Goh P, Tekant Y, Shang NS, Ngoi SS (1992) Laparoscopic cholecystectomy in a patient with empyema of the gallbladder and situs inversus. Endoscopy 24:799–800PubMedGoogle Scholar
  16. 16.
    Takei HT, Maxwell JG, Clancy TV, Tinsley EA (1992) Laparoscopic cholecystectomy in situs inversus totalis. J Laparoendosc Surg 2:171–176PubMedGoogle Scholar
  17. 17.
    Drover JW, Nguyen KT, Pace RF (1992) Laparoscopic cholecystectomy in a patient with situs inversus viscerum: a case report. Can J Surg 35:65–66PubMedGoogle Scholar
  18. 18.
    Campos L, Sipes E (1991) Laparoscopic cholecystectomy in a 39-year-old female with situs inversus. J Laparoendosc Surg 1:123–125PubMedGoogle Scholar
  19. 19.
    Oms LM, Badia JM (2003) Laparoscopic cholecystectomy in situs inversus totalis and the importance of being left-handed. Surg Endosc 17:1859–1861CrossRefPubMedGoogle Scholar
  20. 20.
    Mcdermott JP, Caushaj PF (1994) ERCP and laparoscopic cholecystectomy for cholangitis in a 66-year-old male with situs inversus. Surg Endosc 8:1227–1229PubMedGoogle Scholar
  21. 21.
    Lipschutz JH, Canal DF, Hawes RH, Ruffolo TA, Besold MA, Lehman GA (1992) Laparoscopic cholecystectomy and ERCP with sphincterotomy in an elderly patient with situs inversus. Am J Gastroenterol 87:218–220PubMedGoogle Scholar
  22. 22.
    Djohan RS, Rodriguez HE, Wiesman IM, Unti JA, Podbielski FJ (2000) Laparoscopic cholecystectomy and appendectomy in situs inversus totalis. J Soc Laparoendosc Surg 4:251–254Google Scholar
  23. 23.
    Contini S, Dalla Valle R, Zinicola R (1998) Suspected appendicitis in situs inversus totalis: an indication for a laparoscopic approach. Surg Laparosc Endosc 8:393–394CrossRefPubMedGoogle Scholar
  24. 24.
    Zilberstein B, Di Dio LJ, Eshkenazy R, Sallet JA, Ramos AC (2000) The treatment of portal hypertension by videolaparoscopy in situs inversus totalis. Hepatogastroenterology 47:678–680PubMedGoogle Scholar
  25. 25.
    Cheikhelard A, De Lagausie P, Garel C, Maintenant J, Vuillard E, Blot P, Aigrain Y (2000) Situs inversus and bowel malrotation: contribution of prenatal diagnosis and laparoscopy. J Pediatr Surg 35:1217–1219CrossRefPubMedGoogle Scholar
  26. 26.
    Sato S, Watanabe M, Nagasawa S, Niigaki M, Sakai S, Akagi S (1998) Laparoscopic observations of congenital anomalies of the liver. Gastrointest Endosc 47:136–140PubMedGoogle Scholar
  27. 27.
    Wittgrove AC, Clark GW (1998) Laparoscopic gastric bypass for morbid obesity in a patient with situs inversus. J Laparoendosc Adv Surg Tech A 8:53–55PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Christian Kobus
    • 1
  • Eduardo M. Targarona
    • 1
  • Galit Even Bendahan
    • 1
  • Verónica Alonso
    • 1
  • Carmen Balagué
    • 1
  • Sandra Vela
    • 1
  • Jordi Garriga
    • 1
  • Manuel Trias
    • 1
  1. 1.Servei de CirurgiaHospital de Sant PauBarcelonaSpain

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