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European Journal of Gynaecological Oncology  2021, Vol. 42 Issue (1): 189-192    DOI: 10.31083/j.ejgo.2021.01.2294
Special Issue: Topic Collection "Minimally Invasive Surgery in Gynecological Oncology"
Case Report Previous articles |
Robotic hysterectomy with pelvic lymphadenectomy for early endometrial cancer in a patient with situs inversus totalis using 3D-CT analysis: a case report
Hideaki Yajima1, 2, Eiji Kondo1, *(), Masafumi Nii1, Michiko Kaneda1, Kenta Yoshida1, Tomoaki Ikeda1
1Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, 2-174 Edobashi, Tsu City, 514-8507 Mie, Japan
2Department of Obstetrics and Gynecology, Mie-chuo, Medical Center Hisaimyoujinchou, Tsu City, 2158-5, 514-1101 Mie, Japan
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Abstract  
Background: Pelvic lymphadenectomy should be considered the standard of care for endometrial cancer patients with intermediate-risk. In such cases, lymph node assessment may be performed via a minimally invasive approach. Situs inversus totalis is a congenital condition wherein the major visceral organs are reversed or mirrored from their normal anatomical positions. Reports state that performing surgery on patients with this condition is difficult due to the anatomical abnormality. However, few clinical studies have been conducted to evaluate the efficacy of robotic surgery for endometrial cancer patients with situs inversus totalis because it is technically challenging. Case presentation: A 69-year-old woman with situs inversus totalis (gravida 2 para 2) was brought to our hospital due to a uterine tumor. Endometrial biopsy showed grade 1 endometrioid carcinoma. Using 3 dimensional -computed tomography reconstruction, her common iliac arteries and veins were found to be reversed or mirrored from their normal positions. She underwent hysterectomy with pelvic lymphadenectomy using the multi-articulated arms or 3 dimensional high-definite vision of the da Vinci® surgical system, and 19 lymph nodes were harvested. She was followed up for 24 months without signs of recurrence. Conclusion: The multi-articulated arms or 3 dimensional high-definite vision of the da Vinci® surgical system may be a feasible and safe approach for performing a pelvic lymphadenectomy on patients with situs inversus totalis using 3 dimensional computed tomography analysis.
Key words:  Situs inversus totalis      Robotic hysterectomy      Pelvic lymphadenectomy      Early endometrial cancer     
Submitted:  02 October 2020      Revised:  16 December 2020      Accepted:  28 December 2020      Published:  15 February 2021     
*Corresponding Author(s):  Eiji Kondo     E-mail:  eijikon@clin.medic.mie-u.ac.jp

Cite this article: 

Hideaki Yajima, Eiji Kondo, Masafumi Nii, Michiko Kaneda, Kenta Yoshida, Tomoaki Ikeda. Robotic hysterectomy with pelvic lymphadenectomy for early endometrial cancer in a patient with situs inversus totalis using 3D-CT analysis: a case report. European Journal of Gynaecological Oncology, 2021, 42(1): 189-192.

URL: 

https://ejgo.imrpress.com/EN/10.31083/j.ejgo.2021.01.2294     OR     https://ejgo.imrpress.com/EN/Y2021/V42/I1/189

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