Laparoscopic vs Open Appendectomy in Obese Patients

Acute appendicitis is one of the most common surgical emergencies globally. While surgical removal of the appendix (appendectomy) is the definitive treatment, the optimal surgical approach-laparoscopic versus open-remains widely debated, particularly in obese patients. Obese individuals present unique surgical challenges due to increased abdominal wall thickness, which often necessitates larger skin incisions during open procedures, potentially increasing postoperative pain, wound healing times, and wound complications.

This study aims to compare the postoperative outcomes of laparoscopic appendectomy versus standard open appendectomy in obese patients (BMI ≥ 30 kg/m²) presenting with acute appendicitis. Participants will be randomly assigned to undergo either open appendectomy or laparoscopic appendectomy. The primary outcomes evaluated will be the incidence of surgical site infections (including superficial wound infections and intra-abdominal abscesses) up to 30 days post-procedure and the total length of hospital stay (in days).

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Key information

Conditions

Acute Appendicitis Appendicitis Appendicitis (Diagnosis) Body Weight Cecal Diseases Digestive System Diseases Disease Gastroenteritis Gastrointestinal Diseases Infections Intestinal Diseases Intraabdominal Infections Nutrition Disorders Nutritional and Metabolic Diseases Obesity Overnutrition Overweight Pathologic Processes Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

15 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Obese patients with Body Mass Index (BMI) ≥ 30 kg/m².
Clinical diagnosis of acute appendicitis based on Alvarado score (history of right lower quadrant or periumbilical pain shifting to RLQ, nausea and/or vomiting, fever > 38 °C, RLQ guarding and tenderness, and/or leukocytosis > 10,000 cells/mL).
Age between 15 and 50 years.
Both male and female patients.

Exclusion criteria

Immunocompromised patients (e.g., HIV infection or current steroid therapy).
History of prior chemotherapy, radiotherapy, or recurrent infections.
History of drug or alcohol abuse.
Severe hepatic, renal, or cardiovascular dysfunction.
History of previous abdominal surgery.
Appendicular malignancy.
Pregnant women.
Preoperative findings indicating appendiceal perforation.

Treatment and study plan

open appendectomy

Procedure

Open surgical removal of the appendix performed via a standard grid-iron incision under general anesthesia with standard prophylactic antibiotics.

laparoscopic appendectomy

Procedure

Laparoscopic surgical removal of the appendix using a standard 3-port configuration (umbilical, left iliac fossa, and lower midline ports) under general anesthesia with standard prophylactic antibiotics.

Primary outcomes

Incidence of Surgical Site Infection (SSI)

Time frame: Up to 30 days postoperatively

Proportion of patients who develop a surgical site infection, defined as either superficial/deep wound infection (presence of purulent discharge, erythema, localized swelling, or requiring reopening) or intra-abdominal abscess (confirmed via ultrasound in patients presenting with abdominal pain, fever, or fullness)
Length of Hospital Stay

Time frame: From day of surgery up to discharge (up to 30 days postoperatively)

The total number of days the patient remained in the hospital postoperatively until meeting discharge criteria (afebrile, tolerating a regular diet, and achieving good pain control).

Sponsors and collaborators

Lead sponsor

University of Health Sciences Lahore

Other

Registry information

Official study title

Evaluation of Post Operative Outcomes of Laparoscopic and Open Appendectomy in Obese Patients

Important dates

Study start: 2026
Primary completion: 2027
Study completion: 2027
First posted: Sep 16, 2026
Registry last updated: Sep 16, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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