Dr Rajive conducts laparoscopic surgery on patient of situs inversus

STATE TIMES NEWS

JAMMU: A very rare case of Gall bladder stones in a patient of situs inversus was operated laparoscopically by Dr Rajive Gupta, the eminent laparoscopic surgeon of Jammu at Maxxlyfe Hospital, Bathindi on the evening of January 13,2021.
Patient named Tasveer Akhter, 39 years, wife of Zakir Hussain, resident of Rajouri suffering from epigastric and left upper abdomen pain since six months was advised ultrasound abdomen and was diagnosed by Dr Gupta as a case of situs inversus along with multiple stones in Gall bladder and her X-ray chest showed dextrocardia (Heart located on right side of chest).
According to Dr Gupta, Situs inversus is a very rare genetic condition with an incidence of 1 in 10,000 persons and is characterized by the transposition of organs to the opposite side of the body.
“Though Situs inversus does not predispose one to gall bladder stones, but it leads to diagnostic confusion.” he said adding that the anatomical variation and the contra lateral disposition of biliary tree demands an accurate dissection and exposure of biliary structures to avoid iatrogenic injuries.
In this patient, he said, liver and gall bladder were placed on the left side of abdominal cavity instead of right side.
The mirror image reversibility of the abdominal organs required the surgeon and the assistant to stand on the right side with video monitor on the left side of the patient, Dr Gupta added.
Though difficulty was encountered in skeletonizing the structures in Callot’s triangle, which consumed extra time than normally located gall bladder, yet the operation was performed in just 35 minutes that too by only 3 keyholes over the abdomen.
It was assisted by Cameraman Yoginder and OT assistant Emran Jameer and General Anaesthesia was administered by Dr Pawan.
The patient didn’t require any stitches over the skin and the post operative period was uneventful, Dr Gupta said adding that the patient was made to sit 3 hours after surgery and given liquid sips and discharged after 12 hours and reached her home place Rajouri the next day.
According to Medical Director of Maxxlyfe Hospital, Dr Dushyant Choudhary, this type of surgery in a patient of Situs inversus is very challenging and is technically more demanding and needs reorientation of visual-motor skills and only a senior laparoscopic surgeon like Dr Rajive Gupta can perform such operation.