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Case Report: Laparoscopic Cholecystectomy in a Patient with Situs Inversus Totalis
No full textBackground: Situs inversus totalis is inherited as an autosomal
recessive trait and occurs in approximately 1 per 10 to
20.000 live births. It’s definite as the transposition of both the thoracic
and abdominal viscera to the opposite side of the body.
Case Presentation: D.D. was a 42 y old man who
experienced 6 months prior of his presentation intermittent
nausea,intermittent epigastric pain that radiated laterally to both
sides of upper abdomen,shoulder pain and bloating after some
meals. He received an abdominal US that showed the presence
of gallstones without biliary tree distention, with gallbladder wall
thickening. Patient underwent laparoscopic cholecystectomy.
The operation was carried out in the usual manner with the trocars
placed in locations on the left side of the abdomen as mirror
images to their usual location on the right side. On laparoscopic
examination the intra-abdominal anatomy was the mirror image
of the normal view. Dissection of the triangle Calot and application
of the clip and gallbladder dissection was performed by operator’s
left hand through the subxiphoid trocar.
Conclusions: Some authors suggest that laparoscopic cholecystectomy
in patients with left-sided gallbladder is preferred to
be performed by left handed surgeons due to better ergonomy; we
suggest that surgeon should be right and left handed with experience
in laparoscopy and hepatobiliary surgery
Emergenze plurime di chirurgia addominale e «multiorgan failure» postvascolarizzazione miocardica d’urgenza
No full text
Surgical treatment of lung metastasis: experience with 108 cases
No full textPrima Facolta di Medicina a Chirurgia, Universita degli Studi La Sapienza, Roma
[Reconstruction of the thoracic wall using a Marlex sandwich. Presentation of a clinical case].
No full textThe case of a 78-year-old male with a large, firm, not tender mass of the left anterolateral region of the chest is reported. Previously he had been treated with cyproterone acetate for a year, being affected by a locally unresectable prostate carcinoma. At CT-scan of the chest mass appeared solid, extending to the pleural cavity with compression of the lung and erosion of third to fifth rib. Operation consisted in complete removal of the mass with "en bloc" resection of involved ribs. Chest wall was reconstructed by means of a Marlex mesh sandwich. Histology revealed a carcinoma, probably originating from the breast. The role of antiandrogenic chemotherapy in the development of the tumor and the use of plastic mesh for chest wall defects are discussed
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