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Robotic distal gastrectomy for gastric cancer in a patient with situs inversus totalis and a vascular anomaly

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Abstract

Situs inversus totalis is defined as a complete mirror-image transposition of the thoracic and abdominal viscera. Cancer surgery in patients with situs inversus totalis can be more difficult than in patients without situs inversus totalis; however, robotic surgery using the da Vinci Surgical System allows for intuitive operation with its multi-articular function and stereopsis effect. In addition, prevention of shaking and the motion scale allows for efficient surgical procedures. We evaluated a 64-year-old man who had gastric cancer, and situs inversus totalis and a blood-vessel variation. To facilitate intuitive handling of the robot in this patient with organs reversed from the norm, we arranged the instruments and ports in such a way that the Maryland bipolar forceps could be used with the surgeon’s right hand. We performed a successful robotic distal gastrectomy with lymph node dissection. The operative time was 286 min, and the blood loss was 44 mL. There were no intra- or post-operative complications. The patient was discharged on postoperative day 7 and has had no evidence of a recurrence for 18 months. We conclude that robotic surgery is an efficient tool for operating on patients with gastric cancer, and situs inversus totalis and vessel variations.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467--8601, Japan

    Hiroyuki Sagawa, Sunao Ito, Shunsuke Hayakawa, Shuhei Ueno, Tomotaka Okubo, Tatsuya Tanaka, Ryo Ogawa, Hiroki Takahashi, Yoichi Matsuo, Akira Mitsui, Masahiro Kimura & Shuji Takiguchi

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  1. Hiroyuki Sagawa
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  2. Sunao Ito
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  3. Shunsuke Hayakawa
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  4. Shuhei Ueno
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  5. Tomotaka Okubo
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  6. Tatsuya Tanaka
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  7. Ryo Ogawa
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  8. Hiroki Takahashi
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  9. Yoichi Matsuo
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Correspondence to Hiroyuki Sagawa.

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All procedures described in the report were performed in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Declaration of Helsinki and its later amendments.

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Sagawa, H., Ito, S., Hayakawa, S. et al. Robotic distal gastrectomy for gastric cancer in a patient with situs inversus totalis and a vascular anomaly. Int Canc Conf J 11, 253–260 (2022). https://doi.org/10.1007/s13691-022-00554-x

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  • DOI: https://doi.org/10.1007/s13691-022-00554-x

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