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Bariatric surgery is a specialized surgical discipline. Bariatric surgeons modify the stomach and its connections to treat severe obesity.
This discipline is recognized both by the American College of Surgeons and the National Institutes of Health.
For some severely obese adolescents, behavioral and nutritional approaches to weight loss are unsuccessful. Despite their best efforts, these adolescents are unable to achieve sustained weight loss.
Due to severe obesity, they may suffer from cardiovascular disease, diabetes, and other serious health problems. Even if such problems do not occur during adolescence, they have a high likelihood of occurring in adulthood unless significant weight loss is achieved.
The Surgical Weight Loss Program for Teens within the division of Pediatric Surgery offers these adolescents a surgical weight loss option that serves as another tool for weight management. This tool, however, should be used only when other nonoperative approaches have failed to achieve lasting results.
Appropriate attempts to achieve weight loss through a supervised healthy diet, a behavior modification regimen, exercise, and adopting a physically active lifestyle must first be made. This is essential!
Undergoing surgery is a serious decision that requires careful thought, complete family support, life-long follow-up, and long-term personal commitment to a healthy lifestyle.
With this in mind, severely obese adolescents who suffer life-threatening or potentially life-threatening medical conditions, are highly motivated, have strong family support, and feel that they meet the other criteria discussed above, should inquire about this option.
Studies show that gastric bypass surgery not only improves quality of life and self-esteem, but also improves other co-existing health conditions. These conditions include:
Bariatric surgeons at Cincinnati Children's perform a number of minimally invasive operations for obesity. These include laparoscopic Roux-en Y gastric bypass procedure, laparoscopic sleeve gastrectomy and laparoscopic gastric banding. Decisions are made on an individual basis based on medical assessment and the patient and family's input.
The operations assist in "portion control" by creating a much smaller stomach pouch. The amount of food eaten in a single setting is dramatically reduced.
Two surgical techniques are currently used in performing gastric bypass surgery. This operation can be performed using either the traditional open surgical approach or the newer minimally invasive (laparoscopic) approach. Both of these techniques involve the same surgical principles.
With the laparoscopic approach, specially designed surgical instruments are inserted through small incisions in the abdominal wall.
Since these incisions are much smaller than those required for open surgery, healing and recovery are more rapid and pain and the risk of wound complications is reduced.
Although the laparoscopic approach offers these advantages, not all patients are candidates for this approach. Surgeons must assess each case on an individual basis.
Gastric bypass surgery is recognized by the National Institutes of Health as a safe, well-tolerated, and effective method for weight reduction. The Roux-en Y gastric bypass has been performed and perfected over a 30-year period. The sleeve gastrectomy was originally performed as a first stage prior to Roux en Y for adults with severe obesity who were considered to be too high of a surgical risk for the bypass surgery. The sleeve gastrectomy was found to be effective as a stand alone procedure and has been done as Cincinnati Children’s since 2008. The Adjustable Gastric Band has been approved for use in adults (>18 years old) in the U.S. since 2001. Cincinnati Children's is now spearheading scientific studies funded by the National Institutes of Health to examine the clinical outcomes in this weight loss surgery.
Adolescent obesity and its impact on overall health have become national concerns. As a result, an increasing number of adolescents have undergone this surgery in recent years. Studies indicate that the numerous health benefits they attain are similar to those of adults who have undergone the same operation.
Ninety percent of patients who undergo this surgery lose 60-70% of their excess body weight within the first year of surgery. This initial period of rapid weight loss then gradually reaches a plateau.
Because part of the stomach and small intestine are bypassed, some nutrients are not adequately absorbed. Vitamin and mineral supplements must therefore be taken throughout life in order to maintain overall health.
To assure long-term weight management success, motivation and family support are essential. As well, dietary and lifestyle changes must be adhered to throughout life.
For additional information, view some recent grand rounds presentations on bariatric surgery.
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