Gastric Banding Surgery Shows Success in Pediatric Patients
Based on the encouraging results of a recent study conducted at NYU Medical Center, the NYU Program for Surgical Weight Loss is continuing to offer gastric banding surgery (LapBand®) for obese adolescent patients. With funding from Inamed Health Corporation (a subsidiary of Allergan), 21 eligible patients will be offered the treatment. In addition, it will be offered to another 50 patients pending additional funding. NYU is one of only four institutions nationwide currently approved by the FDA to investigate the efficacy of the procedure on pediatric patients. To date, NYU physicians have the most experience with gastric banding procedures in adolescent patients in the United States.
In the recent study—the first to evaluate the LapBand in patients under the age of 17—patients lost about 50% of their excess weight on average, within one year following surgery. The study, which is published in the January issue of the Journal of Pediatric Surgery, was conducted by NYU faculty Evan Nadler, M.D., Heekoung A. Young, M.D., Howard B. Ginsburg, M.D., Christine J. Ren, M.D., and George A. Fielding, M.D., and was partially funded by the Harris Family Foundation.
LapBand surgery was performed on 53 morbidly obese adolescents between the ages of 13 and 17. According to the study, 12 and 18 months following their surgery, the patients’ average weight loss was comparable to weight loss following a gastric bypass procedure. None of the patients regained any lost weight, which has occurred after gastric bypass procedures, and complications were found to be significantly less severe with the band procedure, as well.
"This study suggests that the LapBand provides a safer and equally effective weight loss strategy compared to the gastric bypass," said Dr. Nadler. "This is good news for parents contemplating obesity surgery for their adolescent children. The bypass has serious risks and side effects associated with it and our study shows that the band provides similar weight loss benefits without the same risks." Intestinal leakage and bleeding, blockage of the intestines, and severe nutritional deficiency are some of the potential side effects associated with the bypass procedure.
The gastric banding procedure places an inflatable silicon ring around the upper portion of the stomach, creating a smaller stomach, which helps patients feel full and limits the amount of food they can eat. The ring is connected to a port that is placed underneath the skin at the time of surgery. At regular visits, the ring can be made tighter or looser by injecting saline into the port. This minimally invasive procedure is usually performed in under an hour. It is reversible, adjustable, and requires no cutting or rerouting of the gastrointestinal tract.
By comparison, during the gastric bypass procedure, the surgeon divides the stomach and reshapes it into a small pouch. It is then connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine.
Eligibility criteria include:
- Be at least 14 and less than 17 years of age at the time of enrollment into the study.
- Have a BMI of at least 40, or a BMI of at least 35 with one or more severe co-morbid conditions.
- Have a history of obesity for at least 5 years, including failed attempts at diet and medical management of obesity.
- Confirmation by a psychologist or psychiatrist experienced with adolescents that the subject is sufficiently mature emotionally to comply with the study protocol.
For more information, contact Dr. Nadler at (212) 263-7391.
