LESSONS FROM THE INITIAL US EXPERIENCE IN GASTRIC BANDING FOR THE TREATMENT OF ADOLESCENT MORBID OBESITY

Abstract

Background: Morbid obesity (MO) affect >15% of adolescents in the US and its incidence is on the rise. Laparoscopic adjustable gastric banding (LAGB) is a restrictive bariatric surgical procedure which has been shown to provide weight loss and improve obesity-related comorbidities in the adults. After refining the surgical technique in our adult patients, we offered LAGB to MO adolescents at our institution. The goal of this study is to report our early results in these adolescents. Hypothesis: LAGB is a safe and effective procedure in both MO adults and adolescent. Methods/Results: Between December 2001 and March 2005, 10 adolescents and 506 adults meeting NIH bariatric criteria underwent LAGB. Outcome measures including BMI (Kg/m2) (body mass index), % EWL (excess weight loss), operative time, length of stay and complications are reported as mean ± SD and tabulated below. Of note, no mortality nor nutritional complications were seen. Conclusions: LAGB as a treatment for MO is an effective and safe weight loss procedure with short operative time, brief hospital stay and no mortality in both patient populations. The reoperative rate for pouch enlargement is however higher in adolescent patients. To reduce the incidence of pouch enlargement, we have incorporated new post-operative management approaches into the treatment protocol for our ongoing FDA-sponsored trial of LAGB in MO adolescents.TABLE