Abstract：
Situs inversus totalis is a rare congenital anomaly. Most surgeons have seldom performed laparoscopy-assisted distal gastrectomy for situs inversus totalis. Inadequate knowledge regarding the anatomy of situs inversus totalis can result in increased intraoperative bleeding and prolonged operative time. A 74-year-old man was diagnosed with early gastric cancer with situs inversus totalis. We performed laparoscopy-assisted distal gastrectomy with D1+ lymphadenectomy and Billroth-I reconstruction by reversing the standard laparoscopy-assisted distal gastrectomy setup. Mirror images of the operative video of the standardized laparoscopy-assisted distal gastrectomy were created using video editing software. Lymphadenectomy was performed by indocyanine green fluorescence imaging of the lymphatic flow with operative time of 220 minutes and 100 mL intraoperative bleeding. The patient was discharged on postoperative day 10, without postoperative complications. Laparoscopy-assisted distal gastrectomy with indocyanine green navigation is safe and effective in patients with situs inversus totalis and is comparable with standard laparoscopy-assisted distal gastrectomy.
摘要：
全位倒位是一种罕见的先天性异常。大多数外科医生很少进行腹腔镜辅助的远端胃切除术。关于全倒位解剖结构的知识不足会导致术中出血增加和手术时间延长。一名74岁的男子被诊断出患有全位倒置的早期胃癌。通过逆转标准的腹腔镜辅助远端胃切除术设置，我们进行了腹腔镜辅助远端胃切除术，并进行了D1淋巴结切除术和Billroth-I重建。使用视频编辑软件创建标准化腹腔镜辅助远端胃切除术的手术视频的镜像。淋巴结清扫术采用吲哚菁绿淋巴流荧光成像,手术时间220min,术中出血100mL。患者于术后第10天出院，无术后并发症。腹腔镜辅助下的远端胃切除术与吲哚菁绿导航是安全有效的，与标准的腹腔镜辅助远端胃切除术相当。
