BACKGROUND: Situs inversus totalis is a relatively rare condition and is an 
autosomal recessive congenital defect in which an abdominal and/or thoracic 
organ is positioned as a "mirror image" of the normal position in the sagittal 
plane. We report our experience of laparoscopic-assisted total gastrectomy with 
lymph node dissection performed for gastric cancer in a patient with situs 
inversus totalis.
CASE PRESENTATION: A 58-year-old male was diagnosed with cT1bN0N0 gastric 
cancer. There were no vascular anomalies on abdominal angiographic computed 
tomography with three-dimensional reconstruction. laparoscopic-assisted total 
gastrectomy was performed with D1+ lymph node dissection, in accordance with the 
Japanese Gastric Cancer Treatment Guidelines. There were no intraoperative 
issues, and no postoperative complications.
CONCLUSIONS: This was the first report describing laparoscopic-assisted total 
gastrectomy with the standard typical lymph node dissection in the English 
literature. We emphasize that the position of trocars and the standing side of 
the primary surgeon during the lymph node dissection are critical.