Ascending colon cancer in a patient with situs inversus totalis: a case report and review of the literature.

INTRODUCTION AND

IMPORTANCE

Situs inversus totalis (SIT) is a rare congenital condition characterized by the complete mirror-image transposition of thoracic and abdominal organs. Performing laparoscopic surgery in such patients presents unique technical and ergonomic challenges due to the reversed anatomy.

CASE PRESENTATION: We report the case of a 60-year-old male who presented with an incidental finding of an ascending colonic tumor during routine investigations. The patient was already known to have SIT. A laparoscopic-assisted ascending hemicolectomy was performed with reversed port placement and mirror-image surgical orientation. The procedure was completed successfully without intraoperative complications, and the postoperative recovery was uneventful.

CLINICAL DISCUSSION: A review of the literature identified 12 previous laparoscopic colectomies, 2 robotic colectomies, and 1 robotic video vignette for ascending colon adenocarcinoma in SIT patients. This case adds to the growing evidence that laparoscopic-assisted colectomy is feasible and safe in SIT, provided that the surgeon is familiar with mirrored anatomy and adapts port placement and team positioning accordingly.

CONCLUSION

Careful preoperative planning and anatomical orientation are key to a successful laparoscopic-assisted colectomy in patients with SIT.