Few treatments are available to help obese adolescents who are unable to lose weight and are already suffering from obesity-related health problems. Laparoscopic adjustable gastric banding (LAGB), an option for adults in the United States since 2001, is showing promise for teens. The Center for Adolescent Bariatric Surgery, which opened at NewYork-Presbyterian Morgan Stanley Children's Hospital in 2006, recently performed its 100th LAGB procedure.
A Single-Incision First
NYPH/Columbia's first single-port laparoscopic sleeve gastrectomy for morbid obesity was performed during fall of 2008. The sleeve gastrectomy is a procedure for surgical weight loss whereby approximately 85% of the stomach is removed, dramatically reducing the patient's capacity for food intake. This procedure is often performed laparoscopically through four or five small incisions; in this case, the surgeon used a specially designed laparoscope and instruments to complete the entire procedure through a single small incision. Other benefits of the single-incision procedure include less pain and quicker recovery. The patient had a smooth recovery.
Offered as Part of Ongoing TOGA Pivotal Trial, Surgery Is Performed Completely Through the Mouth
A NewYork-Presbyterian/Columbia patient was the first in the New York City area to receive incision-free surgery for obesity. The surgery took place during August, 2008 as part of the ongoing multicenter TOGA Pivotal Trial at NYP/Columbia. Drs. Marc Bessler and Daniel Davis performed the TOGA Procedure (for "transoral gastroplasty"), which, like other obesity procedures, is designed to alter the patient's stomach anatomy to give them a feeling of fullness after a small meal. The difference is that TOGA was performed under direct endoscopic visualization with specialized instruments passed into the stomach through the mouth without any incisions.
The Center for Adolescent Bariatric Surgery is geared toward obese teens who would be considered good candidates for laparoscopic gastric band surgery, focusing on those with a body mass index (BMI) of 40 or greater. Patients may also be eligible if they have a BMI of 35 or greater and associated medical conditions such as diabetes, hypertension, sleep apnea, or polycystic ovary disease.
Center for Adolescent Bariatric Surgery Completes 28th Lap-Band Surgery in September 2007
Begun in 2006, the the NYPH/CUMC multidisciplinary Center for Adolescent Bariatric Surgery has conducted 28 successful surgeries as of October, 2007 and is one of a handful U.S. centers presently approved to offer weight loss surgery to adolescents. Geared toward patients who would be considered good candidates for laparoscopic gastric band surgery, the center includes experts in pediatric gastroenterology, endocrinology, nutrition, psychiatry, surgery, and other specialties. Candidates (obese adolescents who have not lost weight with medical management) are evaluated for several months by members of the multidisciplinary team and are offered surgery if they meet medical criteria and have shown solid compliance and weight loss effort.
The Columbia University Center for Metabolic and Weight Loss Surgery is conducting a study to investigate a new, less invasive surgical option to treat weight regain in post-gastric bypass patients. If you were originally successful with your bypass surgery but now find yourself regaining some of your lost weight, you may be a candidate for the EROS procedure.
Test Your Knowledge
Dr. Zitsman Appointment
Jeffrey Zitsman, MD, has been appointed to the Committee on Childhood Obesity of the American Pediatric Surgical Association.
Columbia University Medical Center is one of only three U.S. centers presently approved to offer weight loss surgery to teens as part of a tightly regulated FDA study evaluating the outcomes of "Lap-Banding," in adolescents. Patients in the study must first complete a six-month program of rigorous weight loss education and therapy. "The goal of this phase is to determine whether patients can lose 20% of their excess weight," says Jeffrey L. Zitsman, MD, FACS, Director, Center for Adolescent Bariatric Surgery at Morgan Stanley Children's Hospital of NewYork-Presbyterian. "If patients achieve this goal, they can continue with nonsurgical methods and avoid having surgery."
Click here to go to the Center for Adolescent Bariatric Surgery Website.
After surgery for weight loss, 10-15% of patients may regain weight that they lost. To help such patients, the Center for Metabolic and Weight Loss Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center now performs several types of revisional, or secondary procedures.
Daily News Features Dr. Zitsman & Adolescent Bariatric Center
A December 4, 2006 Daily News article entitled "'Belly Band' Ops Give Teens Hope: City Hosp Leads Fight vs. Obesity" featured the Center for Adolescent Bariatric Surgery at Morgan Stanley Children's Hospital of New York-Presbyterian and its Director, Dr. Jeffrey Zitsman. The program, which recently opened its doors to patients, is one of only three weight loss surgery programs in the U.S. approved by the FDA to operate on children as young as 14.
Columbia Weight Loss Surgery Gets Top HealthGrades Rating
The healthcare ratings organization HealthGrades gave NewYork-Presbyterian Hospital, where Columbia's weight loss surgeons conduct surgery, the highest rating--five stars-- for successful weight loss surgery performed on severely obese patients. The survey is the first of its kind on bariatric, or weight loss, surgery and covered surgeries performed during 2002-2004.
Researchers, who took into account patient risk levels, such as age and heart problems, found that patients in the five-star hospitals were 66 percent less likely to develop a medical complication following surgery compared to a one-star hospital.
Dr. Bessler Receives Bariatric Surgery Appointments
Dr. Marc Bessler has been appointed Associate Editor of the Journal of Surgery for Obesity and Related Diseases, the official journal of the American Society for Bariatric Surgery. He has also been appointed Chairman of the Emerging Technologies committee of the American Society for Bariatric Surgery.
The American College of Surgeons (ACS) has accredited NewYork-Presbyterian Hospital as a Bariatric Surgery Center Network (BSCN) hospital with the highest possible designation (1A), in recognition of the Hospital's ability to offer patients the best care available. The top-level designation is a first for New York state and one of only seven nationwide.
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