Putting the squeeze on fat with new weight-loss surgery for teen
Packard Children’s is first in state to perform pediatric gastric lap band surgery
For Release: May 22, 2006STANFORD, Calif -- It’s another first for Lucile Packard Children’s Hospital. On Thursday, May 18, Packard became the first California children’s hospital to perform a laparoscopic gastric band surgery on an adolescent. The reversible, minimally invasive procedure offers an alternative to gastric bypass surgery to obese teens struggling with major medical complications related to their excess weight. For these kids, weight-loss surgery can be truly life-saving.
“These procedures are for teens suffering from severe, often life-threatening complications of obesity,” said Craig Albanese, MD, chief of pediatric surgery at Packard Children’s and a pioneer in minimal access surgical techniques. “One hundred percent of these teens have very serious medical problems. This isn’t just ‘I want the surgery so I can look better.’” Albanese, together with John Morton, MD, assistant professor of surgery at Stanford University’s School of Medicine, worked together to perform the procedure on the over 400-pound patient who wishes to remain anonymous. Albanese is also a professor of surgery at the medical school.
Diabetes, high blood pressure and joint problems are only a few of the problems that can afflict severely overweight children. Others include liver problems, lung and breathing problems, and increasing pressure in the brain that can cause vision impairment or blindness. These complications don’t only threaten the child’s health and well being, they can also make the surgery itself very challenging. Packard Children’s is one of the few children’s hospitals in the state with the experience necessary to take on such complex cases.
“Often this type of very heavy patient is not offered a laparoscopic weight-loss procedure,” said Morton, who is Director of Bariatric Surgery at Stanford. “However, we were able to draw on our extensive experience in this area to successfully place the lap band using minimal access techniques, even though the patient’s liver was extremely enlarged.” Stanford’s adult program has performed over 1000 weight-loss surgeries, including 100 lap band surgeries.
During the surgery, four to five small incisions are made in the patient’s abdomen and a band about the size of a shower curtain ring is cinched around the upper portion of the stomach to create a small pouch below the esophagus. The constriction slows the passage of food from the pouch into the remainder of the stomach and causes a sensation of fullness after only a few bites.
Unlike the gastric bypass operation, which involves cutting or stapling the stomach to permanently decrease its size, the lap band is removable and adjustable. The interior diameter of the band can be changed by adding or removing a liquid through a port under the skin of the patient’s abdomen. Because lap band patients can eat small quantities of any type of food — in contrast to bypass patients who often have problems digesting sweets— and because they can still feel hungry when full, they experience more gradual weight loss than do bypass patients.
Last Thursday’s procedure took about an hour, and the patient was planning to return home over the weekend. Albanese and Morton anticipate that the lap band procedure will become more common in adolescents if and when the device receives FDA approval for pediatric use.
“The band procedure increases our ability to tailor our treatments to meet the specific needs of each child,” said Albanese. “The lap band might not be for everyone. The bypass might not be for everyone. Even surgery might not be the best answer for some, but we’re committed to offering patient-specific therapy to help kids fight obesity and this is another weapon in our arsenal. These kids are sunk if we don’t help them.”
On Thursday, May 18, 2006, Lucile Packard Children’s Hospital became the first California children’s hospital to perform a laparoscopic gastric band surgery on an adolescent. Pictured L-R monitoring the procedure are Craig Albanese, MD, Chief of Pediatric Surgery at Packard Children's; John Morton, MD, Director of Bariatric Surgery at Stanford; and Sanjeev Dutta, MD, pediatric surgeon at Packard Children’s.
Ranked as one of the nation's top 10 pediatric hospitals by US News & World Report, Lucile Packard Children's Hospital at Stanford is a 264-bed hospital devoted to the care of children and expectant mothers. Providing pediatric and obstetric medical and surgical services and associated with the Stanford School of Medicine, Packard Children's Hospital offers patients locally, regionally and nationally the full range of health-care programs and services from preventive and routine care to the diagnosis and treatment of serious illness and injury. For more information, visit http://www.lpch.org.
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