Minimally invasive Ivor Lewis esophagectomy in a patient with situs inversus totalis through a total of five ports

Sezer Aslan

doi:10.5606/tgkdc.dergisi.2022.20476

Sezer Aslan¹, Çağatay Çetinkaya¹, Ali Fuad Durusoy¹, Hasan Batırel¹

¹Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey

DOI : 10.5606/tgkdc.dergisi.2022.20476

Situs inversus totalis is inverse placement of intra-thoracic and abdominal organs identical with a mirror image. Herein, we present a rare case of situs inversus totalis and gastroesophageal junction carcinoma treated with minimally invasive Ivor Lewis esophagectomy. A 73-year-old male patient presented with dysphagia and a diagnosis of adenocarcinoma was made. He underwent three-port laparoscopic gastric conduit preparation without using a liver retractor. Esophageal mobilization in the chest was completed with biportal video-assisted thoracoscopic surgery technique and a completely side-to-side stapled anastomosis. The patient is still alive without recurrence four years after surgery. Minimally invasive Ivor Lewis esophagectomy can be performed in these cases; however, a careful planning and rethinking of the anatomy for correct intraoperative orientation are needed. Similar surgical and oncological outcomes are expected in this patient population.

Keywords : Esophagectomy, minimally invasive, situs inversus totalis

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