Two Surgeons' Technique for Laparoscopic Cholecystectomy in Situs Inversus for a Right-Handed Surgeon: Technical and Ergonomic Considerations

两位外科医生针对右利手外科医生在内脏反位患者中进行腹腔镜胆囊切除术的技术:技术和人体工程学考量

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Abstract

Laparoscopic cholecystectomy can be technically challenging in patients with situs inversus totalis. A middle-aged gentleman presented with pain in the left upper abdomen. His cardiac workup showed dextrocardia, and ultrasonography showed a gall bladder on the left side. He was diagnosed with acute cholecystitis and was planned for laparoscopic cholecystectomy. We used the four-port technique, where anterior dissection was carried out by the dominant right hand of the primary surgeon, and the infundibulum was retracted by the first assistant from the mid-clavicular port. The first assistant carried out the posterior dissection through a midclavicular port, whereas the primary surgeon did a retraction. To conclude, this technique done by two surgeons decreases the ergonomic difficulty faced by right-handed surgeons while performing laparoscopic cholecystectomy.

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