31.05.2022 | Case report
Robotic distal gastrectomy for gastric cancer in a patient with situs inversus totalis and a vascular anomaly
verfasst von:
Hiroyuki Sagawa, Sunao Ito, Shunsuke Hayakawa, Shuhei Ueno, Tomotaka Okubo, Tatsuya Tanaka, Ryo Ogawa, Hiroki Takahashi, Yoichi Matsuo, Akira Mitsui, Masahiro Kimura, Shuji Takiguchi
Erschienen in:
International Cancer Conference Journal
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Ausgabe 4/2022
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Abstract
Situs inversus totalis is defined as a complete mirror-image transposition of the thoracic and abdominal viscera. Cancer surgery in patients with situs inversus totalis can be more difficult than in patients without situs inversus totalis; however, robotic surgery using the da Vinci Surgical System allows for intuitive operation with its multi-articular function and stereopsis effect. In addition, prevention of shaking and the motion scale allows for efficient surgical procedures. We evaluated a 64-year-old man who had gastric cancer, and situs inversus totalis and a blood-vessel variation. To facilitate intuitive handling of the robot in this patient with organs reversed from the norm, we arranged the instruments and ports in such a way that the Maryland bipolar forceps could be used with the surgeon’s right hand. We performed a successful robotic distal gastrectomy with lymph node dissection. The operative time was 286 min, and the blood loss was 44 mL. There were no intra- or post-operative complications. The patient was discharged on postoperative day 7 and has had no evidence of a recurrence for 18 months. We conclude that robotic surgery is an efficient tool for operating on patients with gastric cancer, and situs inversus totalis and vessel variations.