Abstract A 38-year-old female patient, a known case of situs inversus totalis, underwent laparoscopic sleeve gastrectomy (LSG) for morbid obesity (BMI = 41.3 kg/m2). She had no past medical history and no signs or symptoms of gastroesophageal reflux disease. Situs inversus totalis is a rare congenital developmental defect with a mirror-image replacement of all viscera in both thoracic and abdominal cavity 1. Its incidence is about 1 to 10 000 live births with a male to female predominancy of 1.5 to 1. LSG has been performed safely in the obese situs inversus patients, and several cases have been reported recently 2, 3, 4. We did the LSG in supine position without opening patient legs (American setup) and used both sides of the patient to release the gastric attachments proximally (surgeon at left side), distally (surgeon at right side) and stapling with suture reinforcement (surgeon at left side again). Conversely, surgeon can stand in between of the legs (French setup) but releasing the distal gastric attachments (to the left of the patient) may be more difficult for a right-handed surgeon in this setting. The operation took around 45 min with no complications perioperatively. The patient lost 31 kg of her weight after 5 months post-surgery. She is in good condition now.
Safari et al. (Thu,) studied this question.