Bariatric Surgery

Published on 27/02/2015 by admin

Filed under Pediatrics

Last modified 27/02/2015

Print this page

rate 1 star rate 2 star rate 3 star rate 4 star rate 5 star
Your rating: none, Average: 0 (0 votes)

This article have been viewed 949 times

CHAPTER 28 Bariatric Surgery

As the pediatric obesity epidemic has grown in severity over the past several decades, the use of bariatric surgery in pediatric age groups has also increased by threefold from the late 1990s until 2003. Many bariatric procedures with various modifications have been introduced, including intestinal bypass (jejunocolic or jejunoileal), loop gastric bypass, horizontal and vertical gastroplasty, Roux-en-Y gastric bypass (RYGBP), biliopancreatic diversion (with or without duodenal switch), adjustable gastric banding, and vertical sleeve gastrectomy. Over this spectrum of procedures, one can identify relatively simplistic main goals of each operation: restriction of nutrient intake alone, interference with absorption of nutrients that are ingested, or both. The long-term goal of these procedures is to maintain a degree of weight reduction that improves or eliminates obesity-related co-morbidities or decreases the risk of future obesity-related medical complications and death. Laparoscopic Roux-en-Y gastric bypass, the most common operation in use for adolescents today, will be described in this chapter. Laparoscopic adjustable gastric band and vertical sleeve gastrectomy may also be appropriate alternatives. Each of these operations effectively creates a “tool” that, when used in conjunction with behavioral weight management and close clinical follow-up, will lead to significantly greater weight loss than with any other nonsurgical methods of weight management alone.

Step 2: Preoperative Assessment and Considerations