Abstract
A 51-year-old woman with previously diagnosed situs inversus (SI) totalis was admitted to our hospital with nasal bleeding. Blood tests showed severe thrombocytopenia, with a platelet count of 1.9 × 104/mm3, and idiopathic thrombocytopenic purpura (ITP) was diagnosed. She was refractory to medical treatment, so we performed laparoscopic splenectomy (LS). The mirrorimage anatomy made the procedure difficult for the right-handed surgeon, so we modified the technique to enable it to be performed via an anterior approach through the subxiphoid area using the right hand, with an ultrasonic dissecting device and an endostapling device. The operation was performed safely, the patient recovered uneventfully, and her platelet count normalized. To our knowledge, there has been no other report of LS in a patient with SI; however, it can be performed safely with careful management.
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Nursal TZ, Baykal A, Iret D, Aran O. Laparoscopic cholecystectomy in a patient with situs inversus totalis. J Laparoendosc Adv Surg Tech A 2001;11:239–241.
Al-Jumaily M, Hoche F. Laparoscopic cholecystectomy in situs inversus totalis: is it safe? J Laparoendosc Adv Surg Tech A 2001;11:229–231.
Mimae T, Nozaki I, Kurita A, Takashima S. Esophagectomy via left thoracotomy for esophageal cancer with situs inversus totalis: report of a case. Surg Today 2008;38(11):1044–1047.
Pitiakoudis M, Tsaroucha K, Katotomichelakis M, Polychronidis A, Simopoulos C. Laparoscopic cholecystectomy in a patient with situs inversus using ultrasonically activated coagulating scissors. Report of a case and review of the literature. Acta Chir Belg 2005;105:114–7.
Aydin U, Unalp O, Yazici P, Gurcu B, Sozbilen M, Coker A. Laparoscopic cholecystectomy in a patient with situs inversus totalis. World J Gastroenterol 2006;12:7717–7719.
Wittgrove AC, Clark GW. Laparoscopic gastric bypass for morbid obesity in a patient with situs inversus. J Laparoendosc Adv Surg Tech A 1998;8:53–55.
Contini S, Dalla Valle R, Zinicola R. Suspected appendicitis in situs inversus totalis: an indication for a laparoscopic approach. Surg Laparosc Endosc 1998;8:393–394.
Kobus C, Targarona EM, Bendahan GE, Alonso V, Balaque C, Vela S, et al. Laparoscopic surgery in situs inversus: a literature review and a report of laparoscopic sigmoidectomy for diverticulitis in situs inversus. Langenbecks Arch Surg 2004;389:396–399.
Delaitre B, Blezel E, Samama G, Barrat C, Gossot D, Bresler L, et al. Laparoscopic splenectomy for idiopathic thrombocytopenic purpura. Surg Laparosc Endosc Percutan Tech 2002;12:412–419.
Tan M, Zheng CX, Wu ZM, Chen GT, Chen LH, Zhao ZX. Laparoscopic splenectomy: the latest technical evaluation. World J Gastroenterol 2003;9:1086–1089.
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Yodonawa, S., Goto, Y., Ogawa, I. et al. Laparoscopic splenectomy for idiopathic thrombocytopenic purpura in a woman with situs inversus: Report of a Case. Surg Today 40, 1176–1178 (2010). https://doi.org/10.1007/s00595-009-4183-6
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DOI: https://doi.org/10.1007/s00595-009-4183-6