Innovative Surgical Program in Bariatric Surgery
Obesity in the United States is affecting the pediatric population at an alarming rate. Currently 25-50 percent of America’s children are caught within the spectrum of this disease and as the epidemic advances, there are ever increasing numbers of children in the most severe portion of that spectrum.
These severely afflicted children, who are morbidly obese, are fueling parallel epidemics in the obesity related co-morbidities. These co-morbidities are diseases like hypertension, diabetes and sleep apnea that have traditionally been reserved for adults but are unfortunately common in obese children.
Treating these severely afflicted children by nonsurgical management is generally unsuccessful, or in the rare instance that it is successful, it is associated with a very high rate of recidivism.
Until more effective nonsurgical therapy becomes available, bariatric surgery is a viable option for morbidly obese children to achieve durable and significant weight loss.
This summer, The Children’s Hospital will initiate an innovative new surgical program, the Bariatric Surgery Program, to treat morbidly obese children. This new program will be led by John Bealer, MD, Children’s pediatric surgeon.
“The Bariatric Surgery Program will complement and support the extensive medical programs in obesity care already present at Children’s,” said Dr. Bealer. “When combined, these programs will provide the highest level and most complete care for children afflicted with obesity in the Rocky Mountain region.”
Dr. Bealer will be joined by a multidisciplinary team of pediatric obesity specialists to bring this innovative care to Children’s. Beginning this summer, Dr. Bealer will be performing laparoscopic adjustable gastric banding (Lap-Band®) procedures on a group of carefully selected patients. This procedure involves the placement of an implantable device that encircles the proximal portion of the stomach and is ideally suited for the pediatric population because of its efficacy, safety and reversibility.
The Lap-Band device promotes the sensation of satiety causing weight loss by restricting the entry of food into the proximal stomach. The Lap-Band procedure has an excellent track record of achieving substantial weight loss in the adult population and recently published experience suggests that it is just as efficacious in children.
Morbidly obese adolescents who have undergone the Lap-Band surgery have reported losing 50-60 percent of their excess body weight while completely extinguishing their co-morbidities. This laparoscopic procedure takes less than an hour to perform and is considerably safer than other bariatric procedures because the patient’s normal GI anatomy is not significantly altered. This is a decided advantage over procedures such as the Roux-en-Y gastric bypass surgery that involves substantial alterations in a patient’s anatomy, making them considerably more risky and virtually impossible to reverse.
In addition, since the Lap-Band does not alter normal anatomy, it won’t alter the absorptive capacity of the small intestine and is not associated with malabsorbition or micronutrient deficiencies.
Not all obese patients are candidates for the Lap-Band. Patient candidacy is determined after an exhaustive and lengthy evaluation by the Children’s obesity team. The process usually takes six to nine months and involves
an extensive screening for the known obesity-related co-morbidities, a complete psychological evaluation for the patient and their family, in addition to thorough counseling on the procedure and its risks.
Patients who wish to consider the Lap-Band for treating their obesity are those whose BMI is greater than 40 or those with a BMI greater than 35 and suffering with a co-morbid disease.
New patients who wish to be considered for bariatric surgery are currently being accepted into the Bariatric Surgery Program. To schedule an initial appointment or for additional questions, please call the Pediatric Surgery department at The Children’s Hospital at (720) 777-6571.
