• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Laparoscopic Cholecystectomy in Situs Inversus Abdominis

Laparoscopic Cholecystectomy in Situs Inversus Abdominis

Report of case: A 41 year old woman was referred by a gastroenterologist for chronic abdominal pain of six months’ duration. She described pain that occurred frequently throughout the day, ypically lasting between 30 minutes and two hours. The pain was mainly epigastric but had a colicky right upper quadrant component also. She described severe postprandial attacks that had limited her alimentation to mainly liquids over the previous two months. She had an involuntary weight loss of 8 to 10 pounds over the six month period. An extensive workup including upper and lower endoscopic examinations, a barium swallow with small bowel follow through and a CT scan of the abdomen and pelvis had been done. Salient findings included situs inversus abdominis. The spleen and stomach were on the right, the proximal jejunum and majority of the small intestine were located on the left, while the entire colon was in the right abdomen. The gallbladder was centrally located between two large hepatic lobes. Base on the patient’s symptoms, an abdominal ultrasound and radionuclide hepatobiliary scan were completed. The ultrasound was normal. The radionuclide scan featured normal gallbladder filling and an ejection fraction of 19.8%. A diagnosis of biliary dyskinesia was made.
Technique: The patient was placed in the low lithotomy position with the surgeon positioned between the patient’s legs. Abdominal access was gained with a non-bladed 11mm trocar just superior to the umbilicus. A 30 degree 10 mm laparoscope was used. Additional trocars were placed under direct visualization and included a 5 mm trocar in the right upper abdominal quadrant and two 5 mm trocars in the left upper abdominal quadrant. Anatomical variations included the portal vein crossing anterior to the common hepatic duct and the presence of a very short cystic duct. The dome-down approach was very useful and allowed excellent exposure of critical structures. The cystic duct was isolated, clipped and divided. The gallbladder was removed and the the trocar sites closed.
Results: The patient had an uneventful postoperative recovery and was discharged home the same day. She was seen in the office a week later and was doing well. She remains asymptomatic 8 months after surgery.
Discussion. Gallbladder disease in patients with situs inversus abdominis presents a unique set of challenges centering on significant anatomical abnormalities. The laparoscopic approach is safe and effective. Several modifications may be helpful including variations in patient postitoning, the use of alternate trocar locations and the dome-down dissection technique.


Session: Poster

Program Number: P394

View Poster

400

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals