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CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(05): E625-E629
DOI: 10.1055/a-0581-7101
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Endoscopic submucosal dissection of early gastric cancer via inverted overtube in a patient with situs inversus totalis: a case report

Youichi Miyaoka
1   Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan
,
Shinsuke Suemitsu
2   Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
,
Aya Fujiwara
2   Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
,
Satoshi Kotani
1   Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan
,
Kosuke Tsukano
2   Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
,
Satoshi Yamanouchi
2   Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
,
Ryusaku Kusunoki
2   Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
,
Tatsuya Miyake
3   Division of Liver, Shimane Prefectural Central Hospital, Shimane, Japan
,
Hirofumi Fujishiro
2   Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
,
Naruaki Kohge
2   Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
,
Tomohiko Yamamoto
4   Division of Pathology, Shimane Prefectural Central Hospital, Shimane, Japan
,
Yuji Amano
5   Division of Endoscopy, Kaken Hospital, International University of Health and Welfare, Chiba, Japan
› Author Affiliations
Further Information

Publication History

submitted 25 October 2017

accepted after revision17 January 2018

Publication Date:
08 May 2018 (online)

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Abstract

Background and study aims A 72-year-old man with complete situs inversus presented with early gastric cancer on the lesser curvature wall of the antrum of the stomach. Endoscopic submucosal dissection (ESD) was selected as a treatment. When the patient was positioned in the left decubitus position, the lesion was hidden by blood and gastric fluid because it was located on the gravitational side. Therefore, we decided to perform ESD with the patient in the right lateral decubitus position and use an inverted overtube, which provided a good endoscopic view without the need to rearrange the endoscopist, assistants, or endoscopic system. ESD was safe and feasible using the inverted overtube.

 

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