Gastric Banding Surgery for Teens
(Lap band surgery)
Gastric banding is a form of bariatric surgery. It is used to treat people with severe obesity who have trouble losing weight through diet or exercise alone.
Gastric banding involves putting a small, braceletlike band around the area near the top of the stomach, near to where the esophagus leads into it. The band reduces that part of the stomach to roughly the size of a golf ball. This, in turn, decreases the amount that the person can eat. A doctor can control the size of the opening by inflating or deflating a balloon that is present inside the band.
Weight-loss surgery and teens
Some studies suggest that bariatric or weight-loss surgery for extremely obese teens may improve both their weight and their health. By losing a significant amount of weight, your teen may avoid obesity-linked complications such as type 2 diabetes, sleep apnea, high blood pressure, and heart disease. After the operation, your teen may also escape the bullying, teasing, and social isolation that some overweight adolescents experience.
Experts are unsure, however, about the long-term consequences for a teen's developing body. Weight-loss surgery may weaken teens' bones, for example. A recent study found that teens who underwent weight-loss surgery experienced an average loss of 7.4 percent of their bone mass. Because the teen years mark the peak of bone development, the researchers urge that teens be carefully monitored after the surgery.
Like all operations, weight-loss surgery also involves some risk, including hernia, infection, internal bleeding, blood clots, and death. Your teen may also have to make permanent changes in his or her lifestyle, including eating only small portions of food and taking daily vitamin and mineral supplements—steps that impulsive teenagers may not be inclined to do.
When eating, the small pouch at the top of the stomach will fill up quickly. As a result, your teen will feel full after eating a small amount of food. The pouch then empties slowly into the bottom part of the stomach. Once the gastric band is in place, eating more than the pouch can handle can lead to vomiting and other problems. Your teenager may also experience problems if the gastric band erodes or slips out of place.
For these reasons, doctors will generally advise the surgery only if a teen has tried to lose weight for at least six months without success and has other health problems linked to obesity, such as type 2 diabetes. Because data on long-term studies are not yet in, the New England Journal of Medicine recommends that such surgeries for teens be approached with caution and used only for those who are "morbidly obese"—those who have a body mass index (BMI) of at least 40 with co-existing medical conditions, or a BMI of 50 or more.
Other criteria your child should meet:
Your teen should have reached physical maturity.
Your teen should show evidence of mental and emotional maturity.
Your teen should have a supportive family and not have an untreated eating disorder or psychiatric illness.
The weight-loss procedure should be performed only in a bariatric center with adequate staffing.
Before the procedure:
A gastric banding procedure is a major life change that patients need to take seriously. Your teen will likely be asked to take classes that explain what is involved with the procedure and what life will be like after the procedure, particularly as it pertains to diet.
Your child will also need to have ultrasounds, blood tests, and other tests to ensure that he or she is healthy enough for surgery.
Your teen may need to see a mental health counselor to make sure he or she is mentally ready for the surgery.
Teens will also have to have a complete physical exam.
The doctor may ask the teen to stop taking certain medications during the week leading up to the surgery.
Be sure your teen does not eat or drink anything starting at midnight the night before the surgery.
Based upon your teen's medical condition, the doctor may request other specific preparations.
During the procedure
A gastric banding surgery usually requires a hospital stay of about 24 hours. Your teen may be asked to check in the day before or the morning of the procedure. Procedures may vary, depending on your teen's specific condition and the doctor's practices. Generally, a gastric banding surgery follows this process:
Your teen will receive general anesthesia before the surgery, and he or she will be completely asleep during the procedure.
The surgeon will make one to five small cuts in the abdomen.
Through these small cuts, the surgeon will place instruments needed to perform the surgery, including small camera that allows the surgeon to see what he or she is doing during the surgery.
Using these tools and camera, the surgeon will place a small, flexible band around the top portion of the stomach. This divides the stomach into a small pouch at the top and a larger lower portion.
The procedure may take 30 to 60 minutes, depending on its complexity.
After the procedure
After gastric banding surgery, it's normal for your teen to feel some pain and discomfort. This is usually treated with general pain relievers. Your teen's health care team may also try to get him or her up and walking to assist in the recovery process.
On the day after surgery, your teen will probably have an X-ray to ensure that the gastric band is working properly. He or she may be asked to swallow a liquid that can be seen on the X-ray.
Eating will be much different after the surgery, and the counseling done before the surgery is meant to help prepare your teen for this.
- Bass, Pat F. III, MD, MPH
- Pierce-Smith, Daphne, RN, MSN-FNP, CCRC