A Case of Situs Inversus Totalis with Gallbladder Stones Treated by Laparoscopic Surgery

Situs inversus totalis, also known as mirror man, is an extremely rare anatomical variant in which the positions of the thoracic and abdominal organs are reversed. This case is novel due to the combination of situs inversus totalis and gallbladder stones, presenting unique surgical challenges. Reporting this case underscores the importance of preoperative imaging and surgical technique adjustments for achieving a successful laparoscopic cholecystectomy in such rare anatomical variants. A 58-year-old female patient presented with recurrent left-sided low back pain for over 2 months, exacerbated in the previous 2 days. She had no major medical history. Imaging revealed gallbladder stones with situs inversus totalis. Preoperative evaluation included comprehensive imaging to assess biliary tract variations. Laparoscopic cholecystectomy was performed using a three-port approach, with careful adjustments for the mirrored anatomy. The operation was successful, with minimal intraoperative bleeding (20 mL) and no complications. The patient recovered well, started eating and mobilising on the first postoperative day and was discharged on the third day. Follow-up at 3 months showed no considerable discomfort, and a 1-year telephone follow-up confirmed sustained recovery. This case highlights the importance of thorough preoperative imaging and surgical planning in managing patients with situs inversus totalis. The successful laparoscopic cholecystectomy demonstrates that, with careful preparation and technique adjustments, minimally invasive surgery can be safely performed even in rare anatomical variants. This experience provides valuable insights for surgical teams encountering similar cases, emphasising the need for meticulous preoperative assessment and intraoperative adaptability.