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      Robot-assisted distal gastrectomy for gastric cancer in a situs inversus totalis patient

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      Publication date:
      Journal: Journal of the Korean Surgical Society
      Publisher: The Korean Surgical Society
      Keywords: gastric cancer, situs inversus totalis, robot surgery

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          Abstract

          A 47-year-old man was referred to Seoul National University Bundang Hospital with an ulcerative lesion in the midbody of the stomach. Computed tomography revealed that he was a situs inversus totalis (SIT) patient. Robot-assisted distal gastrectomy with D1+β lymph node dissection and Billroth II anastomosis were performed. With the aid of robotic surgery, the surgeon didn't need to change his position and could perform the surgery without any confusion resulting from the patient's reversed anatomy. The operation took 300 minutes, with no intraoperative complications. The postoperative course was uneventful, and the patient was discharged on postoperative day 8. The final pathologic report was pT3N3a by American Joint Committee on Cancer 7th tumor-node-metastasis staging. We successfully performed robot-assisted distal gastrectomy for gastric cancer in a SIT patient. We believe that this is the first case of robotic surgery reported in a SIT patient with gastric cancer.

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          Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures.

          W. Kang, S Noh, S. Choi … (2009)
          To evaluate the technical feasibility, effectiveness, and safety of robot-assisted gastrectomy (RAG) with lymphadenectomy, using the da Vinci system through analyses of our initial series of 100 consecutive patients. The application of robotic surgery was proven to be one of the best cutting-edge technologies for successful minimally invasive surgery by providing solutions to the many drawbacks of laparoscopic surgery, yet few reports have studied robotic surgery in gastric cancer. A review of a prospectively designed database at our institute from July 2005 to October 2007 revealed a series of 100 consecutive RAG patients with a preoperative diagnosis of early gastric cancer. Clinicopathologic characteristics and surgical outcomes were analyzed. All operations were performed successfully without open or laparoscopic conversion. There were 33 total gastrectomies and 67 subtotal gastrectomies with D1+beta or extended lymphadenectomy (D2). The mean total operation time and console time were 231 and 150 minutes, respectively. There were 13 postoperative morbidities and 1 postoperative mortality. The first flatus was noted on postoperative day 2.9, soft diet was started on postoperative day 4.2, and the mean postoperative hospital stay was 7.8 days. Although all patients were diagnosed as early gastric cancer preoperatively, the final pathology report revealed that 19 patients exhibited a depth deeper than T2. The mean number of retrieved lymph nodes was 36.7 (range, 11-83). None of the specimens showed microscopic tumor involvement in the resection line. This study demonstrated that RAG with lymphadenectomy can be applied safely and effectively for patients with gastric cancer.
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            Left-sided acute appendicitis with situs inversus totalis: review of 63 published cases and report of two cases.

            Alper Caliskan, Sami Akbulut, Abdülselam Ekin … (2010)
            Situs inversus (SI) and midgut malrotation (MM) are uncommon anatomic anomalies that complicate diagnosis and management of acute abdominal pain. We present two cases of left-sided acute appendicitis with situs inversus totalis and a literature review of studies published in English language on left-sided acute appendicitis, accessed via Pubmed and Google Scholar database. Sixty-three published cases of left-sided acute appendicitis were evaluated, and two patients (M:16 yr, F:17 yr) who presented to our clinic with left lower quadrant pain caused by left-sided acute appendicitis were reported. Thirty-five of the patients were male and 30 were female (including our patients) with age range from 8 to 63 years and median age of 26.7 +/- 14.0 years. Fifty-three patients had situs inversus totalis (SIT), 8 had MM and two were with malrotation of the caecum. Thirty-eight patients had applied to the hospital with left lower quadrant pain, 12 with right and 6 with bilateral lower quadrant pain. Thirty patients were diagnosed as having SIT or MM, while the diagnosis in 12 patients was established during the intraoperative period. Eleven patients with SIT were aware of having this anomaly. Five of the patients underwent laparoscopic appendectomy and in two patients laparoscopic appendectomy and cholecystectomy were performed in one session. Preoperative diagnosis has been easier to achieve after 1985, when ultrasonography (USG) and computed tomography (CT) were introduced into the medical practice. SIT and MM should be taken into consideration in patients with findings of the physical examination suspicious for left-sided acute appendicitis. X-ray, USG, CT and diagnostic laparoscopy are beneficial in developing the differential diagnosis.
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              Laparoscope-assisted distal gastrectomy for early gastric cancer in a 76-year-old man with situs inversus totalis.

              S Yamaguchi, H. Sakata, M. Hashizume … (2003)
              We report a case of a 76-year-old man with situs inversus totalis (SIT) who developed early gastric cancer. He was successfully treated by laparoscope-assisted distal gastrectomy for the gastric cancer. This case suggests that patients with SIT with malignancy could also undergo laparoscopic surgery. To the best of our knowledge, no case of laparoscopic surgery for malignant neoplasms associated with SIT has been reported in the English literature. We therefore believe this is the first case report.
              Article 0 comments Cited 21 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Korean Surg Soc
                Journal ID (iso-abbrev): J Korean Surg Soc
                Journal ID (publisher-id): JKSS
                Title: Journal of the Korean Surgical Society
                Publisher: The Korean Surgical Society
                ISSN (Print): 2233-7903
                ISSN (Electronic): 2093-0488
                Publication date (Print): May 2012
                Publication date (Electronic): 26 April 2012
                Volume: 82
                Issue: 5
                Pages: 321-324
                Affiliations
                [1 ]Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
                [2 ]Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
                Author notes
                Correspondence to: Do Joong Park. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 463-707, Korea. Tel: +82-31-787-7097, Fax: +82-31-787-4055, djpark@ 123456snubh.org
                Article
                DOI: 10.4174/jkss.2012.82.5.321
                PMC ID: 3341483
                PubMed ID: 22563541
                SO-VID: 6b381fc5-a496-46ce-86ce-096907293d10
                Copyright © Copyright © 2012, the Korean Surgical Society
                License:

                Journal of the Korean Surgical Society is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 05 August 2011
                Date revision received : 16 October 2011
                Date accepted : 12 December 2011
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Keywords: gastric cancer,situs inversus totalis,robot surgery
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: gastric cancer, situs inversus totalis, robot surgery

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