Left video-assisted thoracoscopic surgery esophagectomy in a patient with situs inversus totalis and Kartagener syndrome.

A 67-year-old man with situs inversus totalis and Kartagener syndrome was diagnosed with esophageal adenocarcinoma after presenting with chronic gastroesophageal reflux. Resection of the tumor was done by minimally invasive Ivor-Lewis esophagectomy using a left video-assisted thoracoscopic surgery approach, rather than the typical right video-assisted thoracoscopic surgery. Patients with situs inversus totalis may be considered for fully minimally invasive esophagectomy with laparoscopic gastric mobilization and video-assisted thoracoscopic surgery esophagectomy with an intrathoracic anastomosis using a similarly opposite-sided approach. Patients with Kartagener syndrome are also at increased risk for respiratory tract infections. This should be considered in the perioperative period, as well as when considering induction chemoradiation therapy.