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Operative Challenges with Minimally Invasive McKeown Esophagostomy with Two-Field Lymphadenectomy in a Case of Situs Inversus Totalis with Carcinoma Esophagus: A Case Report with Review of the Literature

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Abstract

Situs inversus totalis is an uncommon anatomical congenital anomaly characterized by complete transposition of viscera with right-to-left reversal across the sagittal plane. Consequently, surgery in such cases is more technically challenging and requires a complete reorientation of visual-motor coordination skills. We describe a case of a 50-year-old gentleman with locally advanced lower esophagus carcinoma post-neoadjuvant chemoradiotherapy with situs inversus totalis and treated with minimally invasive McKeown esophagectomy using a left thoracoscopic, laparoscopic-assisted and right cervical approach. The operative procedure and difficulties during surgery are highlighted. Minimal invasive esophagectomy is safe and feasible in situs inversus totalis. Recognition of the anatomy with a meticulous preoperative planning is advocated for an uneventful operative intervention.

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Authors and Affiliations

  1. Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India

    Syed Nusrath, S. Murtaza Ahmed, B. Madhunarayana, K. V. V. N. Raju, T. Subramanyeshwar Rao & Sujit Chyau Patnaik

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  1. Syed Nusrath
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  2. S. Murtaza Ahmed
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  3. B. Madhunarayana
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  4. K. V. V. N. Raju
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  5. T. Subramanyeshwar Rao
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  6. Sujit Chyau Patnaik
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Correspondence to Syed Nusrath.

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Nusrath, S., Murtaza Ahmed, S., Madhunarayana, B. et al. Operative Challenges with Minimally Invasive McKeown Esophagostomy with Two-Field Lymphadenectomy in a Case of Situs Inversus Totalis with Carcinoma Esophagus: A Case Report with Review of the Literature. Indian J Surg Oncol 11, 662–667 (2020). https://doi.org/10.1007/s13193-020-01132-4

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  • DOI: https://doi.org/10.1007/s13193-020-01132-4

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