Laurent Genser1, Claude Tayar, Imad Kamal Eddine. 1. Assistance Publique-Hôpitaux de Paris (AP-HP), Department of General and Hepatobiliary Surgery, Henri Mondor University Hospital, Créteil Cedex, France, laurent.genser@gmail.com.
Abstract
BACKGROUND: Single incision laparoscopic sleeve gastrectomy (SILSG) has proven to be a safe minimal invasive procedure. The umbilicus placement of the device allows the avoidance of any visible scars. Kartagener syndrome is a rare genetic disorder (1:15 000) accompanied by the combination of chronic sinusitis/bronchiectasis leading to respiratory insufficiency and situs inversus totalis (SIT) in half of the patients. SIT is a transposition of organs to the opposite side of the body and can lead to difficulties in laparoscopic surgery because of mirror image anatomy modification. METHODS: We present the case of a 52-year-old woman (122 kg; 1.58 m) with a body mass index of 49 kg/m(2) presenting SIT with chronic respiratory insufficiency as part of Kartagener syndrome. RESULTS: In this multimedia video, we present a step-by-step trans-umbilical SILSG completed in SIT condition. Single site approach allows several technical advantages such as single-port placement, surgeon position as well as surgical instruments manipulation that are unchanged compared to "normal anatomy patients." These resulted in limited intra-operative difficulties. No adverse outcomes occurred during the post-operative period. CONCLUSIONS: Trans-umbilical SILSG in patients with SIT can be performed safely and in comparable conditions than in normal anatomy patients.
BACKGROUND: Single incision laparoscopic sleeve gastrectomy (SILSG) has proven to be a safe minimal invasive procedure. The umbilicus placement of the device allows the avoidance of any visible scars. Kartagener syndrome is a rare genetic disorder (1:15 000) accompanied by the combination of chronic sinusitis/bronchiectasis leading to respiratory insufficiency and situs inversus totalis (SIT) in half of the patients. SIT is a transposition of organs to the opposite side of the body and can lead to difficulties in laparoscopic surgery because of mirror image anatomy modification. METHODS: We present the case of a 52-year-old woman (122 kg; 1.58 m) with a body mass index of 49 kg/m(2) presenting SIT with chronic respiratory insufficiency as part of Kartagener syndrome. RESULTS: In this multimedia video, we present a step-by-step trans-umbilical SILSG completed in SIT condition. Single site approach allows several technical advantages such as single-port placement, surgeon position as well as surgical instruments manipulation that are unchanged compared to "normal anatomy patients." These resulted in limited intra-operative difficulties. No adverse outcomes occurred during the post-operative period. CONCLUSIONS: Trans-umbilical SILSG in patients with SIT can be performed safely and in comparable conditions than in normal anatomy patients.
Authors: Fatih Mehmet Yazar; Arif Emre; Sami Akbulut; Aykut Urfalıoğlu; Emrah Cengiz; Mehmet Sertkaya; Hüseyin Yıldız; Ertan Bülbüloğlu Journal: Indian J Surg Date: 2016-01-21 Impact factor: 0.656