A Backwards Approach to Bariatric Surgery: The Perioperative Approach Used in a Woman with Situs Inversus Totalis Undergoing a Laparoscopic Sleeve Gastrectomy

Situs inversus totalis is a rare congenital condition where organs are mirrored across the sagittal plane of the body. In the absence of associated comorbidities, most people have normal health and lifespan. Challenges with mirrored image anatomy arise when needing an operative procedure involving the intraabdominal organs. There are few reported cases in the literature of laparoscopic surgery in patients with situs inversus, with even fewer in the field of bariatric surgery. Obesity and obesity-related comorbidities continue to increase in our society, and bariatric surgery is a treatment option for weight loss. We report the perioperative approach used in a 59-year-old obese woman with confirmed situs inversus totalis undergoing laparoscopic sleeve gastrectomy.