To summarize the advantages and difficulties of da Vinci robotic surgery in patients with complete organ transposition, and to explore the feasibility and safety of da Vinci robotic surgery for pancreaticoduodenectomy in patients with complete organ transposition.

Situs inversus totalis (SIT) is a rare congenital anatomic anomaly in which the normal anatomic position of the thorax and abdomen presents a mirror inversion. Therefore, surgeons face a great challenge when operating on patients with thoracic and abdominal organ tumors due to anatomical changes. Da Vinci robotic surgical system came out at the end of last century. The advantages of this surgical system in minimally invasive pancreatic surgery are becoming more and more obvious, and more and more clinical applications have achieved good results. In Oct. 2022, a patient with complete organ transposition was admitted to the Department of Hepatobiliary and Pancreatic Surgery of the First Medical Center of the Chinese People′s Liberation Army General Hospital. After complete preoperative examination, the patient was diagnosed as pancreatic head cancer with obstructive jaundice. After adequate preoperative evaluation, the da Vinci Si pancreaticoduodenectomy was performed.

Postoperative recovery was good, no obvious complications occurred during follow-up.

There are many advantages in da Vinci robotic surgery for patients with complete organ transposition, but there are still some difficulties. Through the diagnosis and treatment process of this patient, the feasibility and safety of da Vinci robotic surgery for pancreaticoduodenectomy in patients with complete organ transposition are proved.