Robot-Assisted Gastrectomy and Sigmoid Colectomy with Situs Inversus Totalis: A Case Report

摘要

INTRODUCTION: Situs inversus totalis is a rare congenital disorder defined as mirror-image transposition of the thoracoabdominal organs, and surgical strategies remain controversial owing to the associated anatomical abnormalities. Although laparoscopic and robot-assisted surgeries are gaining popularity, no reports have been published on robot-assisted gastrectomy and sigmoid colectomy for situs inversus totalis at the same time. CASE PRESENTATION: A 77-year-old woman with situs inversus totalis presented to our hospital with type 0-IIa+IIc sigmoid colon cancer and type 0-IIc gastric cancer. Therefore, we decided to perform robot-assisted gastrectomy and sigmoid colectomy. The port positions were the same for both procedures, and the robot rolled in from the opposite side of the body. The surgery was successful, and the postoperative course was uneventful. CONCLUSIONS: While we did not experience any challenges during distal gastrectomy, we experienced difficulty in dissecting toward the root of the inferior mesenteric artery during sigmoid colectomy. To address this problem, port transportation can be improved.