J Korean Surg Soc.  2012 May;82(5):321-324.

Robot-assisted distal gastrectomy for gastric cancer in a situs inversus totalis patient

• Kim HB
• Lee JH
• Park DJ
• Lee HJ
• Kim HH
• Yang HK

Abstract

A 47-year-old man was referred to Seoul National University Bundang Hospital with an ulcerative lesion in the midbody of the stomach. Computed tomography revealed that he was a situs inversus totalis (SIT) patient. Robot-assisted distal gastrectomy with D1+beta lymph node dissection and Billroth II anastomosis were performed. With the aid of robotic surgery, the surgeon didn't need to change his position and could perform the surgery without any confusion resulting from the patient's reversed anatomy. The operation took 300 minutes, with no intraoperative complications. The postoperative course was uneventful, and the patient was discharged on postoperative day 8. The final pathologic report was pT3N3a by American Joint Committee on Cancer 7th tumor-node-metastasis staging. We successfully performed robot-assisted distal gastrectomy for gastric cancer in a SIT patient. We believe that this is the first case of robotic surgery reported in a SIT patient with gastric cancer.

Keyword

Situs inversus totalis; Robot surgery; Gastric cancer

MeSH Terms

Gastrectomy
Gastroenterostomy
Humans
Intraoperative Complications
Joints
Lymph Node Excision
Middle Aged
Situs Inversus
Stomach
Stomach Neoplasms
Ulcer

Figure

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  Fig. 1 Computed tomography showing transposition of abdominal organs; there were no lymph node or distant metastasis in the abdomen.

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  Fig. 2 The placements of ports.

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  Fig. 3 (A) Robotic view showing transposition of abdominal organ. (B) Left (right in normal) gastroepiploic artery was exposed. (C) D1 + β lymph node dissection was completed. (D) Gastro-jejunostomy was made.

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