{"title":"Two Cases of Single-Incision Laparoscopic Surgery for Sigmoid Colon and Rectal Cancer in Situs Inversus Totalis.","authors":"Mamoru Miyasaka, Koichi Teramura, Shuji Kitashiro, Yuki Okawa, Sho Sekiya, Daisuke Saikawa, Satoshi Hayashi, Yoshinori Suzuki, Masaya Kawada, Yo Kawarada, Kichizo Kaga, Shunichi Okushiba, Satoshi Hirano","doi":"10.70352/scrj.cr.24-0016","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Situs inversus totalis (SIT) is a rare congenital disorder characterized by the complete inverted transposition of the thoracic and abdominal viscera. This anatomical variation complicates laparoscopic surgery, and there are currently no reports of single-incision laparoscopic surgery (SILS) for patients with sigmoid colon cancer or rectal cancer with SIT.</p><p><strong>Case presentation: </strong>We performed SILS on 2 patients with sigmoid colon and rectal cancers who also had SIT. The first case involved a 64-year-old woman with sigmoid colon cancer. A 3.5 cm umbilical incision was made, and SILS was performed using a single-port surgical device with three 5 mm trocars placed in the incision. The sigmoid colon was resected with a linear stapler, which required switching from a 5 mm trocar to a 12 mm trocar. Laparoscopic anastomosis was performed using the double-stapling technique. The second case involved an 81-year-old man with dual cancers located in the sigmoid colon and lower rectum, 8 cm from the anal verge. The abdominal approach was performed using SILS, similar to the first case, along with a transanal total mesorectal excision (TaTME) from the perineum by 2 teams. Anastomosis was performed laparoscopically using a single-stapling technique. Neither patient experienced postoperative complications, and both remained free of recurrence at 42 and 7 months, respectively.</p><p><strong>Conclusions: </strong>SILS is a feasible approach for patients with sigmoid colon cancer or rectal cancer and SIT.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946454/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.70352/scrj.cr.24-0016","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/25 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Situs inversus totalis (SIT) is a rare congenital disorder characterized by the complete inverted transposition of the thoracic and abdominal viscera. This anatomical variation complicates laparoscopic surgery, and there are currently no reports of single-incision laparoscopic surgery (SILS) for patients with sigmoid colon cancer or rectal cancer with SIT.
Case presentation: We performed SILS on 2 patients with sigmoid colon and rectal cancers who also had SIT. The first case involved a 64-year-old woman with sigmoid colon cancer. A 3.5 cm umbilical incision was made, and SILS was performed using a single-port surgical device with three 5 mm trocars placed in the incision. The sigmoid colon was resected with a linear stapler, which required switching from a 5 mm trocar to a 12 mm trocar. Laparoscopic anastomosis was performed using the double-stapling technique. The second case involved an 81-year-old man with dual cancers located in the sigmoid colon and lower rectum, 8 cm from the anal verge. The abdominal approach was performed using SILS, similar to the first case, along with a transanal total mesorectal excision (TaTME) from the perineum by 2 teams. Anastomosis was performed laparoscopically using a single-stapling technique. Neither patient experienced postoperative complications, and both remained free of recurrence at 42 and 7 months, respectively.
Conclusions: SILS is a feasible approach for patients with sigmoid colon cancer or rectal cancer and SIT.