Bariatric surgery is the most effective treatment for severe obesity and its associated medical conditions. Situs inversus totalis presents a mirror-image anatomical variation that can complicate laparoscopic procedures. Technical adaptations are required to achieve safe and effective outcomes. A 47-year-old woman (BMI 40.1 kg/m²) with situs inversus totalis, hypertension, and insulin-dependent type 2 diabetes underwent a mirror-image, step-by-step, one anastomosis gastric bypass performed laparoscopically. Recovery was uneventful. At twelve months, she achieved 56.4% excess weight loss and significant improvement in her medical conditions. Laparoscopic one anastomosis gastric bypass with mirror-image trocar placement and counterclockwise bowel manipulation is safe and effective in SIT patients, allowing similar outcomes.
Ferreira et al. (Wed,) studied this question.