Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file
Abstract Background Situs inversus is a rare congenital condition that is currently classified into two types: complete situs inversus (situs inversus totalis, SIT) and partial situs inversus (situs inversus partialis, SIP). In SIP patients, some organs are inverted and others are in their expected...
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Japan Surgical Society
2018-02-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-018-0422-7 |
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| author | Yuki Aisu Yoshio Kadokawa Shigeru Kato Daiki Yasukawa Yusuke Kimura Tomohide Hori |
| author_facet | Yuki Aisu Yoshio Kadokawa Shigeru Kato Daiki Yasukawa Yusuke Kimura Tomohide Hori |
| author_sort | Yuki Aisu |
| collection | DOAJ |
| description | Abstract Background Situs inversus is a rare congenital condition that is currently classified into two types: complete situs inversus (situs inversus totalis, SIT) and partial situs inversus (situs inversus partialis, SIP). In SIP patients, some organs are inverted and others are in their expected position, and individual patient variation in organ position increases surgical difficulty. Several surgeons have performed laparoscopic or robotic surgeries in situs inversus patients, but almost all were SIT patients. We report the first case, to our knowledge, of an SIP patient with gastric cancer who was successfully treated by robot-assisted distal gastrectomy (RADG) with lymph node dissection. Case presentation A 64-year-old woman diagnosed with early gastric cancer on the posterior midbody of the stomach was referred to our hospital for treatment. Computed tomography showed levocardia and inverted abdominal organs without enlarged lymph nodes or distant metastases. Polysplenia syndrome, intestinal malrotation, and left-sided gallbladder were also detected. RADG with D1+ lymph node dissection and Billroth I reconstruction (delta-shaped anastomosis) were performed using robotics. Hepatopathy caused by a liver retractor and pancreatic fistula were identified during the postoperative course, and the latter was classified as grade II based on Clavien-Dindo classification. The patient was discharged 18 days after the operation. Conclusions Preoperative three-dimensional imaging is beneficial, and anatomical organ identification should be routinely performed, especially in SIP patients. We consider RADG a therapeutic option in SIP patients. |
| format | Article |
| id | doaj-art-c4de0ea874c14ab6be9c435ed4c91ca3 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2018-02-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-c4de0ea874c14ab6be9c435ed4c91ca32025-08-20T02:51:41ZengJapan Surgical SocietySurgical Case Reports2198-77932018-02-01411610.1186/s40792-018-0422-7Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video fileYuki Aisu0Yoshio Kadokawa1Shigeru Kato2Daiki Yasukawa3Yusuke Kimura4Tomohide Hori5Department of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo HospitalDepartment of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo HospitalDepartment of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo HospitalDepartment of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo HospitalDepartment of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo HospitalDepartment of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo HospitalAbstract Background Situs inversus is a rare congenital condition that is currently classified into two types: complete situs inversus (situs inversus totalis, SIT) and partial situs inversus (situs inversus partialis, SIP). In SIP patients, some organs are inverted and others are in their expected position, and individual patient variation in organ position increases surgical difficulty. Several surgeons have performed laparoscopic or robotic surgeries in situs inversus patients, but almost all were SIT patients. We report the first case, to our knowledge, of an SIP patient with gastric cancer who was successfully treated by robot-assisted distal gastrectomy (RADG) with lymph node dissection. Case presentation A 64-year-old woman diagnosed with early gastric cancer on the posterior midbody of the stomach was referred to our hospital for treatment. Computed tomography showed levocardia and inverted abdominal organs without enlarged lymph nodes or distant metastases. Polysplenia syndrome, intestinal malrotation, and left-sided gallbladder were also detected. RADG with D1+ lymph node dissection and Billroth I reconstruction (delta-shaped anastomosis) were performed using robotics. Hepatopathy caused by a liver retractor and pancreatic fistula were identified during the postoperative course, and the latter was classified as grade II based on Clavien-Dindo classification. The patient was discharged 18 days after the operation. Conclusions Preoperative three-dimensional imaging is beneficial, and anatomical organ identification should be routinely performed, especially in SIP patients. We consider RADG a therapeutic option in SIP patients.http://link.springer.com/article/10.1186/s40792-018-0422-7CancerGastrectomySitus inversusRobotic surgeryRobot |
| spellingShingle | Yuki Aisu Yoshio Kadokawa Shigeru Kato Daiki Yasukawa Yusuke Kimura Tomohide Hori Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file Surgical Case Reports Cancer Gastrectomy Situs inversus Robotic surgery Robot |
| title | Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file |
| title_full | Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file |
| title_fullStr | Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file |
| title_full_unstemmed | Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file |
| title_short | Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file |
| title_sort | robot assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis a case report with video file |
| topic | Cancer Gastrectomy Situs inversus Robotic surgery Robot |
| url | http://link.springer.com/article/10.1186/s40792-018-0422-7 |
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