Children's Hospital Colorado
Center for Children's Surgery
Center for Children's Surgery

Single-Incision Pediatric Endoscopic Surgery

At Children’s Hospital Colorado, our surgeons understand that parents have a lot of questions when they hear the phrase, “Your child needs surgery.” Families are often concerned about recovery time, safety, scarring and complications. To minimize these worries and provide the best care for kids and teens, surgeons at Children’s Colorado are constantly developing and refining new techniques to improve patient outcomes and experiences, such as minimizing incisions and scarring. One of these innovative surgical methods is called Single-Incision Pediatric Endoscopic Surgery or SIPES, a leading-edge minimally-invasive surgical method.

SIPES: an alternative to traditional types of surgery

Traditional forms of surgery include open surgery and minimally-invasive laparoscopic surgery. Open surgery is done through a large incision, and laparoscopic surgery is done through three to five small incisions.

We use these traditional forms of surgery to treat patients and have excellent outcomes. Although these patients heal well, sometimes the scarring left by the incision(s) of traditional surgery creates parental concern, potential for an access site complication and a potential need for future plastic reconstructive surgery. This is when Single-Incision Pediatric Endoscopic Surgery (SIPES) can be a good surgical option.

Excellent outcomes, quick recovery, invisible incision and minimal scarring

Similar to traditional surgery, SIPES has excellent patient outcomes. In fact, single-incision surgery is nearly the same surgery as traditional surgery. The difference is that it is performed through one tiny incision hidden at the bottom of the belly button instead of with large or multiple incisions.

In contrast to traditional surgery, a single-incision approach offers patients:

  • Minimal scarring: Single-incision surgery is performed through a 1-centimeter incision hidden at the bottom of the belly button. Following surgery, patients will have almost no visible reminders as they grow into teens and young adults. 
  • Shorter hospital stays: Open surgery requires a long incision that can take weeks to heal completely, but with a SIPES procedure, the recovery is much quicker due to the smaller incision size. That means less healing and shorter hospital stays.
  • Reduction in the number for access sites

Who’s eligible for single-incision surgery?

Although almost everyone is eligible regardless of weight or age, there may be certain circumstances, for example a prior surgery, where a traditional laparoscopic or open surgery may be preferable for safety. Based on each patient’s individual circumstances, our surgeons will make recommendations and work with families to decide which approach will have the best outcome.

How long does single-incision surgery last?

This type of surgery will take almost the same amount of time as laparoscopic surgery. 

Will my child be in pain?

Before surgery, patients are put under anesthesia. This induces a sleep-like state where the patient won’t feel pain during the procedure. Our pediatric anesthesiologists are specially trained to keep kids safe and pain-free during surgery.

After the operation, patients may feel some discomfort around the belly button, which can last on average one to two days. Following more complex procedures, patients may feel some discomfort in the abdomen due to the use of gas during surgery. The gas creates space in the abdomen, which allows the surgeon better visualization.

How long will my child stay at the hospital?

In comparison to the five to seven day hospital stay of traditional open surgery, a SIPES hospital stay is shorter. You can expect on average, two to four days.

How will I care for my child after single-incision surgery?

The single incision is hidden within the confines of the belly button. Patients leave the operating room with a small gauze bandage on their belly button covered by a transparent dressing. The dressing stays on for two days. Bathing with soap and running water is permitted, but sitting in a tub or swimming should be avoided for a week.

Why choose Children’s Hospital Colorado for single-incision surgery?

Our board-certified pediatric surgeon trained at the hospital with the highest volume of single-incision surgeries in the world. Utilizing advanced technology, our surgeon provides excellent medical and cosmetic outcomes for patients.

Conditions treated with single-incision or SIPES plus surgery

  • Gastrostomy
  • Appendectomy
  • Cholecystectomy
  • Splenectomy
  • Total colectomy
  • Ovarian cysts
  • Small bowel resections
  • Reduction of intussusception
  • Abdominal biopsies
  • Diagnostic laparoscopy
  • Leveling colostomy for Hirschsprung disease
  • Laparoscopic-assisted pull-through

What our patients are saying about their SIPES experience

“I can’t see my scar at all.” 

– Daphne Peraza, 11 year-old-patient

"Daphne's stomach was hurting a lot, so we went to the Children's Colorado location near Parker. They sent us to Children's Colorado Anschutz Campus in an ambulance. After we got here, they did some tests to see if she would need an appendectomy. Then, we met with Dr. Marwan and he said that he could do Daphne's surgery through her belly button. I thought that this was great because it's important for kids, especially girls, not to grow up with scars. She should be able to wear a bikini when she's older. Now, we can't see her scar. It's amazing. The scar won't remind her of the surgery."

– Sandro Peraza, Daphne's dad

“I was having a lot of pain in my stomach at home. So, I told my mom that we need to go to the hospital. We came to Children’s Colorado Anschutz Campus in an ambulance. It was 7 p.m. when we got here and by 8 p.m. I was headed into surgery. Dr. Marwan said he could do my surgery through my belly button. I like that I don’t have a scar. I can’t see it.” 

– Ximena Sotelo-Rivera, 8-year-old patient

“I am happy with Ximena’s surgery. It’s good. I like that we can’t see her scar. It’s better than having big ones on her stomach.” 

– Maria Elena, Ximena’s mom

“On Christmas eve, we came to the hospital. At first, we weren’t sure that it was Darisse’s appendix – they couldn’t tell with the imaging. Dr. Marwan said he would go in to do a diagnostic laparoscopy through her belly button and that if it was her appendix, he could take it out. As a girl, we thought it would be great for Darisse to only have one small scar instead of three. We actually can’t even see the scar at all. We ended up going home the same night. She didn’t need any pain medication after we left the hospital, just some Tylenol. The entire process went as well as it could have.” 

– Valerie Pelletier, Mom of 8-year-old patient Darisse


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