While the number of gastric bypass surgeries being performed each year is going up as obesity rates continue to rise in most western countries, a lot of people still believe that surgery is not the right solution for obesity in children. Nonetheless, this could be changing and, although numbers are still relatively small, teenage gastric bypass surgeries increased by 300% between 2000 and 2003.
Overall, lap band surgery is a simple procedure where, in short, a small implant is placed around the top portion of the stomach to form a 'gastric pouch'.
A 'gastric band' with a small balloon inside is attached around the top portion of your stomach, forming a smaller 'gastric pouch'. The placement of the band creates a small pouch at the top of the stomach that holds up to approximately 30 ml, which works out to about 1/8 cup. You are inclined to eat less because the pouch holds less food than the whole stomach. As the upper part of the stomach registers itself as being full, it sends a message to the brain saying that the entire stomach is full. This is the main principle behind the lap band procedure; this tightening of the stomach feeling or sensation helps the person to be hungry less often, to eat smaller portions and lose weight over time.
Interestingly enough, the entire lap band operation is fully reversible! The lap band is the only weight loss surgery that is reversible. That's because gastric band placement, unlike other procedures like malabsorptive weight loss surgery (an example would be Roux-en-Y gastric bypass surgery), doesn't cut or remove any part of the stomach or the digestive system. It's usually easy to remove the band and reverse the surgery, requiring only a laparoscopic procedure, after which point the stomach should return back to its normal pre-banded state.
The question of the long term effects of weight loss surgery is of course one which will only be answered with time, when a large enough group of teenagers has had surgery and we have produced some meaningful statistics. During 2003 in excess of 105,000 gastric bypass operations were performed but fewer than 800 of these operations were carried out on teenage patients. Even if we consider this to be a meaningful sample size from which we can draw conclusions about the long term effects of surgery, we still have to wait many years before drawing such conclusions.
As far as the success of the procedure itself is concerned, teenagers have proved to be excellent candidates for surgery, requiring shorter hospitalization, recovering quickly and demonstrating fewer problems both during and following surgery. This is not surprising when you think that most teenagers go into surgery without the many medical conditions that are frequently seen in adults. Perhaps most important of all, the death rate from gastric bypass surgery among teenagers is a lot less than that seen in adults.
As well as those concerns related to surgery itself there is also the wider question of whether or not we should be looking at surgery at all with adolescents. Patients having gastric bypass surgery have to make considerable changes to their lifestyle and have to deal with a number of psychological issues both prior to and following surgery. It is hard enough to ask adults to tackle these issues, but a lot of people are asking whether or not this is a burden that we should be putting on teenagers.
The evidence to hand at this point suggests that weight loss surgery is an effective answer to the problem of obesity in teenagers but more time is needed to assess the long term effects of surgery and to study the psychological aspects of surgery before this can become a widespread solution to the problem of obesity in youngsters.
A number of patients are able to go back to their normal routine after a few days of rest. Researchers have proved that laparoscopic surgery reduces the incidence of complications after the surgery, and fewer cases of hernias were reported than in those patients who had open procedures.
Even though the advantages of undergoing laparoscopic obesity surgery greatly outweigh the disadvantages, the patient should be aware of any complications that are related to this surgery. Any decision regarding the choice of the surgical procedure should be taken after a lengthy discussion with the bariatric surgeon.