Gastric Banding Surgery for Teens

(Lap band surgery)

Gastric banding is a form of weight-loss (bariatric) surgery. It is used to treat people with severe obesity who have trouble losing weight through diet or exercise alone.

Procedure overview

Gastric banding involves putting a small, braceletlike band around the area near the top of the stomach. The band is put close to where the esophagus leads into the stomach. The band makes that part of the stomach much smaller. It is about the size of a golf ball. This small size decreases the amount of food the person can eat. A doctor can control the size of the opening by inflating or deflating a balloon that is inside the band.

Weight-loss surgery and teens

Some studies suggest that weight-loss surgery for extremely obese teens may improve both their weight and their health. By losing a lot of weight, your teen may avoid health problems linked to obesity. These include type 2 diabetes, sleep apnea, high blood pressure, and heart disease. After the operation, your teen may also escape the bullying, teasing, and social problems that some overweight teens experience.

But experts are unsure about the long-term consequences of gastric banding for a teen's developing body. Weight-loss surgery may weaken teens' bones, for example. A recent study found that teens who had weight-loss surgery lost an average of 7.4% 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.

Risks and possible complications

Like all operations, weight-loss surgery also involves some risk. This includes hernia, infection, internal bleeding, blood clots, and death. Your teen will also have to make permanent changes in his or her lifestyle. This means eating only small amounts of food and taking daily vitamin and mineral supplements. These are things that impulsive teenagers may not want to do.

When your teen eats, 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 have 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 6 months without success and has other health problems 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 used only for those who are "morbidly obese." This means teens who have a body mass index (BMI) of at least 40 and have other health conditions, or those who have a BMI of 50 or more. 

Other criteria your child should meet:

  • Your teen should have reached physical maturity.

  • Your teen should be mentally and emotionally mature.

  • Your teen should have a supportive family.

  • Your teen should not have an untreated eating disorder or mental illness.

  • The weight-loss surgery should be done only in a bariatric center with enough medical staff.

Before the procedure

  • A gastric banding procedure is a major life change that your teen needs to take seriously. Your teen will likely be asked to take classes that explain what is involved with the procedure. He or she will learn what life will be like after the procedure, especially diet.

  • Your teen will also need to have ultrasounds, blood tests, and other tests to make sure 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.

  • Your teen will also need a complete physical exam.

  • The doctor may ask your teen to stop taking certain medicines 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 health condition, the doctor may ask for 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 get general anesthesia before the surgery. Your teen will be completely asleep during the procedure.

  • The surgeon will make 1 to 5 small cuts in the belly (abdomen).

  • Through these small cuts, the surgeon will place instruments needed to do the surgery. These include a small camera that lets the surgeon see what he or she is doing during the surgery.

  • Using these tools and camera, the surgeon will put a small, flexible band around the top part of the stomach. This divides the stomach into a small pouch at the top and a larger lower part.

  • The procedure may take 30 to 60 minutes, depending on how complicated it is.

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 healthcare team may also try to get him or her up and walking. This will help your teen recover faster.

On the day after surgery, your teen will probably have an X-ray to make sure 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. The counseling done before the surgery is meant to help get your teen ready for this.  

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