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Situs inversus totalis (SIT) is a rare condition where the abdominal and thoracic cavity structures are opposite of their usual position. Laparoscopic colonic surgery for this patient population is not well described, with only 2 reported cases. Our patient was a 62-year-old female with a history of SIT who underwent a laparoscopic sigmoid colectomy for recurrent diverticulitis. The procedure included the use of 4 ports. The sigmoid colon was noted on the right side. Laparoscopic resection with stapled anastomosis was performed. The patient tolerated the procedure well and was discharged home on postoperative day 5 without complications. We present a third case of laparoscopic colectomy for diverticulitis in a patient with SIT and a description of the operative procedure.

Crohn's disease is commonly complicated by perianal manifestations. The surgeon plays a pivotal role in caring for these patients; a detailed history along with a thorough clinical exam provides the treating physician with invaluable information upon which to base further investigations and management decisions. Other than abscess drainage, medical management to control proximal disease often precedes any surgical attempt to cure the disease. Surgical interventions are indicated in selective patients, but are often complicated by poor wound healing and recurrences. A sizable percentage of these patients may need a proctectomy.