Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2022; 13(10): 848-852
Published online Oct 24, 2022. doi: 10.5306/wjco.v13.i10.848
Ascending colon cancer and situs inversus totalis – altered surgeon position for successful laparoscopic hemicolectomy: A case report
Ji-Long Hu, Qi-Yun Li, Kun Wu
Ji-Long Hu, Qi-Yun Li, Kun Wu, Department of Abdominal Tumor Surgery, Jiangxi Cancer Hospital, Nanchang 330000, Jiangxi Province, China
Author contributions: Hu J, Wu K, and Li Q treated the patient, reviewed the literature, and contributed to manuscript drafting; All authors approved the final version.
Informed consent statement: Informed written consent was obtained from the patient for publication of this manuscript and the accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors read the CARE Checklist (2016) and prepared the manuscript in accordance with it.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qi-Yun Li, MD, Chief Physician and Surgeon, Department of Abdominal Tumor Surgery, Jiangxi Cancer Hospital, No. 519 Beijing East Road, Qingshan Lake District, Nanchang 330000, Jiangxi Province, China. liqiyun878@sina.com
Received: April 19, 2022
Peer-review started: April 19, 2022
First decision: May 31, 2022
Revised: June 8, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: October 24, 2022
Processing time: 183 Days and 21 Hours
Abstract
BACKGROUND

Situs inversus totalis (SIT) is a rare congenital condition in which the structure of the abdominal and thoracic cavities is the mirror image of normal. This anatomic reversal makes laparoscopic surgery difficult when treating colorectal cancer.

CASE SUMMARY

We describe the successful laparoscopic hemicolectomy of a 68-year-old Chinese woman with SIT and ascending colon cancer. Based on preoperative imaging and careful consideration of the patient’s anatomy, the position of the surgeon was modified such that the surgeon stood between her legs, while the surgical assistant and endoscopist stood to the surgeon’s left. Trocar position was also adjusted appropriately. The surgery lasted 178 min, during which the patient lost 50 mL of blood. Pathology analysis of the resected tumor confirmed an adenocarcinoma in clinical stage pT3N0M0, without lymph node involvement. The patient experienced no postoperative complications and was discharged 10 d after surgery.

CONCLUSION

This case illustrates that careful positioning of the surgeon can facilitate laparoscopic surgery of SIT patients.

Keywords: Colon cancer; Situs inversus totalis; Laparoscopic surgery; Case report

Core Tip: Situs inversus totalis (SIT) is a rare congenital anomaly in which the organs in the chest and abdomen are located in a mirror image reversal of their normal positions. We present a rare case of SIT accompanied by colon cancer. After careful consideration of the patient’s anatomy, we modified the position of the surgeon to enable successful laparoscopic hemicolectomy. This case highlights that careful positioning of the surgeon can make laparoscopic surgery feasible and safe for SIT patients.