Situs viscerum inversus totalis is a rare condition with a genetic predisposition that is autosomal recessive. We present a case in an elderly patient with transposition of the viscera and cholelithiasis, who was successfully treated with laparoscopic cholecystectomy. This paper further expands the application of this technique and shows that they can be safely and effectively applied in the setting of situs viscerum inversus totalis, although attention must be paid to the details of left-right reversal.