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Int J Surg Case Rep. 2019;60:371-375. doi: 10.1016/j.ijscr.2019.06.038. Epub 2019 Jun 22.

Robot-assisted Toupet fundoplication and associated cholecystectomy in symptomatic giant hiatal hernia with situs viscerum inversus-A case report and literature review.

Author information

1
Department of General Surgery, "San Giovanni Battista" Hospital, Foligno, Italy; Department of Surgery, Division of General Surgery, "San Donato" Hospital, Arezzo, Italy. Electronic address: g.cecca2003@libero.it.
2
Department of General Surgery, "San Giovanni Battista" Hospital, Foligno, Italy. Electronic address: angelaromano_ar@libero.it.
3
Department of General Surgery, "S. Veneziale", Isernia, Italy. Electronic address: Giuseppedottesposito@gmail.com.
4
Department of General Surgery, "San Giovanni Battista" Hospital, Foligno, Italy. Electronic address: michele.derosa@nhs.net.
5
Department of General Surgery, "San Giovanni Battista" Hospital, Foligno, Italy. Electronic address: walterbugiantella@alice.it.
6
Department of Surgery, Division of General Surgery, "San Donato" Hospital, Arezzo, Italy. Electronic address: egidiomiranda@gmail.com.
7
Department of Surgery, Division of General Surgery, "San Donato" Hospital, Arezzo, Italy. Electronic address: fonta79@gmail.com.
8
Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: vito.dandrea@uniroma1.it.

Abstract

INTRODUCTION:

Giant hiatus hernia is defined as migration of >30% of the stomach with or without other intra-abdominal organs into the chest. Situs Viscerum Inversus is a rare congenital condition in which the major visceral organs are reversed from their normal arrangement; they are translated (completely or partially) on the opposite side of the body. Diagnosis is often incidental. We report a Robot-assisted Toupet fundoplication for a giant hiatal hernia with gastro oesophageal reflux disease and cholelithiasis, in a 63-years-old woman with situs viscerum inversus.

PRESENTATION OF CASE:

A 63-year-old woman with Situs Viscerum Inversus was diagnosed with giant sliding hiatus hernia. We performed a Robot-assisted procedure of reduction of hiatal hernia in abdomen and Toupet fundoplication with Bio A mesh placement and gastropexy procedure associated to cholecystectomy. The operation time was of 190min. The patient was discharged on third postoperative day after X-ray check and he tolerated a solid food.

DISCUSSION:

Minimally invasive surgery represents, nowadays, the standard approach for hiatal hernia and cholelithiasis.

CONCLUSION:

In challenging cases as the giant hernias ad rare anomaly as situs viscerum inversus, the surgical treatment can be facilitated by the use of robotic technology.

KEYWORDS:

Cholecystectomy-case report; Gastro oesophageal reflux disease; Giant hiatal hernia; Mesh placement; Robotic surgery; Situs Viscerum Inversus; Toupet fundoplication

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