title: Single incision pediatric endosurgery (SIPES) appendectomy--is obesity a contraindication?
abstract: BACKGROUND
  Single-incision pediatric endosurgery (SIPES) is gaining popularity and has been reported to be safe in acute (non-perforated) and perforated appendicitis. The feasibility of SIPES appendectomy in obese children is uncertain.
  
  
  METHODS
  After IRB approval, data were collected from a prospectively maintained SIPES appendectomy database for cases performed between April 2009 and March 2012. Patients were divided into obese and non-obese groups based on Center for Disease Control criteria. The surgical techniques, operative times, complications, conversion rates, and outcomes were recorded. Chi-square test and t-test were used for statistical analysis.
  
  
  RESULTS
  SIPES appendectomy was attempted in 500 children. There were 21% obese, and 37% were female with median age of 10.9 ± 3.8 years. Mean operative time, blood loss, requirement of additional trocars, and intraoperative complications in non-obese and obese children were not significantly different. Mean hospital stay (2.3 days in each group), post operative wound infections (3.3% vs. 4.8%, p=0.55, non-obese vs. obese), and intraabdominal abscesses (4.3% vs. 2.9%, p=0.77, non-obese vs. obese) were not significantly different.
  
  
  CONCLUSIONS
  SIPES appendectomy may be accomplished successfully and safely in obese children. Obesity did not appear to be associated with increased risk of complications and was not a contraindication for SIPES appendectomy.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Govardhana R
authors.initials: GR
authors.lastname: Yannam
authors.forename: Russell
authors.initials: R
authors.lastname: Griffin
authors.forename: Scott A
authors.initials: SA
authors.lastname: Anderson
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Beierle
authors.forename: Mike K
authors.initials: MK
authors.lastname: Chen
authors.forename: Carroll M
authors.initials: CM
authors.lastname: Harmon
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Appendectomy; Laparoscopy; Obesity; Pediatrics; SIPES; Single incision