“It's important for someone like me to get data from a good place, like the University of Illinois at Chicago, to help make decisions in the future,” Dr. Helmrath said.
Dr. Robert E. Kramer agreed that systematic, evidence-based data are needed on surgical options to help the 11 million obese children in the United States. Laparoscopic adjustable gastric banding is attractive because “if there are complications, or it doesn't seem successful, there at least is the option of removing the device and going back to the original anatomy,” said Dr. Kramer, medical director of a pediatric obesity clinic at the University of Miami.
“We see a lot of teenagers who come in, and they're looking for a quick fix,” he said in an interview. “It's difficult for them to truly appreciate the risk associated with bariatric surgery.” For that reason, he favors restricting bariatric surgery for adolescents to tertiary care centers that offer it as part of a comprehensive obesity management program for children.
The LAP-BAND device is shown in the correct 45-degree position before a final adjustment (left). After surgery, esophageal and gastric pouch emptying without dilation is evident (right). Photos courtesy Dr. Ai-Xuan Le Holterman
