A Case of Single Incision Laparoscopic Surgery for Treatment of Acute Appendicitis with Total Situs Inversus

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 34; no. 3; pp. 681 - 684
• Main Authors: Nakata, Ryosuke, Suzuki, Hideyuki, Komine, Osamu, Nomura, Satoshi, Chihara, Naoto, Watanabe, Masanori, Uchida, Eiji
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 31.03.2014
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.34.681

A 54-year-old man, in whom situs inversus totalis had been present from early childhood, was admitted with a fever and left lower quadrant pain. An enlarged appendix with a fecalith in the left lower quadrant was revealed on plain abdominal CT scan imaging. Acute appendicitis with situs inversus totalis was diagnosed, and an emergency operation was determined. Single-incision laparoscopic surgery was performed using a multi-channel port (LAP PROTECTORTM), which was inserted through a 2.0 cm umbilical incision. Three trocars were placed in the multi-channel port. Situs inversus totalis is a rare anomaly (incidence 1: 5,000 to 1: 10,000) characterized by the complete inversion of all abdominal and thoracic organs. Due to the abnormal anatomical location, diagnosis may be difficult and great care must be taken during surgery. Laparoscopic surgery for patients with this anomaly is a useful method, which can allow minimal invasive observation of the abdominal cavity and diagnosis is easily converted to treatment. It is also superior in terms of the cosmetic result if single incision surgery can be performed completely as in this case, because the need for any additional ports is assessed after observation of the focus status.