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01.12.2015 | Case report | Ausgabe 1/2015 Open Access

BMC Surgery 1/2015

Laparoscopic-assisted total gastrectomy for early gastric cancer with situs inversus totalis: report of a first case

BMC Surgery > Ausgabe 1/2015
Mamoru Morimoto, Tetsushi Hayakawa, Hidehiko Kitagami, Moritsugu Tanaka, Yoichi Matsuo, Hiromitsu Takeyama
Wichtige Hinweise

Competing interest

The authors declare that they have no competing interests.

Authors’ contributions

All six authors were involved in planning, data collection, analysis of case and writing the manuscript. MM, TH, and HK performed surgical procedures. MM and MT managed the patients. MM collected data and wrote the paper. YM and HT reviewed it. All authors approved the final manuscript.



Situs inversus totalis is a relatively rare condition and is an autosomal recessive congenital defect in which an abdominal and/or thoracic organ is positioned as a “mirror image” of the normal position in the sagittal plane. We report our experience of laparoscopic-assisted total gastrectomy with lymph node dissection performed for gastric cancer in a patient with situs inversus totalis.

Case presentation

A 58-year-old male was diagnosed with cT1bN0N0 gastric cancer. There were no vascular anomalies on abdominal angiographic computed tomography with three-dimensional reconstruction. laparoscopic-assisted total gastrectomy was performed with D1+ lymph node dissection, in accordance with the Japanese Gastric Cancer Treatment Guidelines. There were no intraoperative issues, and no postoperative complications.


This was the first report describing laparoscopic-assisted total gastrectomy with the standard typical lymph node dissection in the English literature. We emphasize that the position of trocars and the standing side of the primary surgeon during the lymph node dissection are critical.
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