[Laparoscopic cholecystectomy in situs inversus: the disadvantage of being right-handed.]. / Colecistectomía laparoscópica en situs inversus: la desventaja de ser diestro.

OBJECTIVE: To expose our institutional experience on biliary tract surgery in patients with situs inversus. BACKGROUND: Situs inversus is a rare condition of genetic origin, which leads mandatory the modification of surgical technique in laparoscopic cholecystectomy. METHODS: Report of two cases of laparoscopic cholecystectomy in patients with situs in versus. CONCLUSIONS: Laparoscopic cholecystectomy would seem to be the first-line surgical procedure for the treatment of patients with symptomatic gall bladder stones and situs inversus; albeit it imposes special technical demands, it provides the same outcomes of the patients with normal anatomy.

[Laparoscopically created stomas]. / Estomas por laparoscopia.

PURPOSE: The aim of this paper is to present the results obtained in five cases with a stoma created by the laparoscopic approach. PATIENTS AND METHOD: Analysis of five patients who required a stoma as treatment for their diseases or as a complementary management of another medical problem from March 1999 to May 1999. There were three women and two men. Mean age was 43 years (range 20-59 years). Two women had a rectovaginal fistula secondary to radiation proctitis, another woman presented an infected sacral wound, one man suffered a sphincteric lesion that required sphincteroplasty, and the other man had Fournier's gangrene. Surgical technique included the use of two ports, one at the umbilicus for the camera and the other at the site previously chosen for the stoma. RESULTS: Mean surgical time was 30 min (range 20-40 min), transoperative bleeding was meaningless; all stomas began to function during the first 24 h after the procedure. One patient began oral intake on the first day, three patients on the second day, and one patient was intubated in the intensive care unit and for this reason was unable to eat. All stomas achieved the objective sought and there were no complications related to the procedure. CONCLUSIONS: Stoma creation by the laparoscopic approach may offer advantages over the open-surgery technique.