Hand-Assisted Laparoscopic Donor Nephrectomy in Complete Situs Inversus

Laparoscopic Living Donor Nephrectomy in a Donor With Situs Inversus Totalis: It is Not a Contraindication to Kidney Transplant

Situs inversus totalis (SIT) is a rare anatomic anomaly representing 180° inversion of all internal organs. We report a case of laparoscopic living donor nephrectomy in a donor with SIT. A 55-year-old man volunteered to provide a living kidney source for his son. The donor was in good physical condition, with no clinical history of obesity, hypertension, diabetes, and other abnormalities. Preoperative X-ray thoracic and abdominal scans showed that the donor had a total organ transposition inversus. Computed tomographic renal vascular three-dimensional reconstruction scan showed that the patient had 2 left renal arteries and 1 right renal artery. All data collected comply with the Helsinki Congress and the Declaration of Istanbul. We chose to perform a transabdominal route laparoscopic living donor nephrectomy of the right kidney. The donor did not experience operation-related complications and was discharged on the fourth postoperative day. The recipient did not have a rejection reaction, and the recipient recovered successfully. This case illustrates that laparoscopic living donor nephrectomy is fully feasible in this population.

Robot-assisted partial nephrectomy for T1b renal cell carcinoma with complete situs inversus totalis with pre- and intraoperative three-dimensional virtual imaging

Complete Situs Inversus Totalis (SIT) is a rare congenital anomaly characterized by the transposition of organs to a totally inverted position. We present a case of Robot-Assisted Partial Nephrectomy (RAPN) for T1b renal hilum tumor (RENAL score 9) with SIT. All procedures were performed safely using preoperative three-dimensional (3D) virtual image assistance. There were no intraoperative complications, and the patient was discharged uneventfully. Pathological diagnosis confirmed papillary renal cell carcinoma type1. In patients who have renal cancer with SIT, RAPN can be performed safely, and 3D virtual imaging could provide successful surgical outcomes.

Living donor hand-assisted laparoscopic nephrectomy in a healthy individual with situs inversus totalis: no need to turn down the donor

A 70-year-old healthy male individual offered to undergo a living donor hand-assisted laparoscopic nephrectomy to enable kidney transplantation for a close relative. As required for all living transplant donor candidates, extensive screening was performed to exclude potential contraindications for donation. Tests revealed a situs inversus totalis, meaning a complete transposition of the thoracic and abdominal organs in the sagittal plane. As other contraindications for living kidney donation were absent, the feasibility of this procedure was determined multidisciplinary. A successful donation procedure was performed without surgical complications for the donor and good short-term transplant outcomes. In line with current developments that have resulted in more liberal criteria for potential living kidney donors, major anatomical deviations should not automatically be a contraindication. With multidisciplinary efforts and thorough surgical preparation at a high-volume transplant centre, this procedure is feasible and safe.