How Many Pediatric Hospitals Are Performing Lap Bands?

Obesity-related illnesses like diabetes, high blood pressure, and fatty liver are not only on the rise, but striking younger people. In an effort to arrest the momentum of this rising epidemic, four pediatric hospitals--the Children's National Medical Center in Washington, the Cincinnati Children's Hospital Medical Center, the Lucile Packard Children's Hospital in California, and Driscoll Children's Hospital in Texas--perform Laparoscopic Adjustable Gastric Band (lap band) procedures on morbidly obese children and adolescents.

Lap Band Facts

The lap band narrows the width of a patient's stomach opening, which restricts the quantity of food that can enter and fools the stomach into feeling full, so the patient eats far less and loses his or her excess weight at a healthy rate. The FDA has not yet approved the lap band procedure for use in children and adolescent patients. Acceptance of lap band procedures in a pediatric context remains mixed.

Benefits

Lap band procedures are less invasive than other surgical weight loss operations, including gastric bypass, according to Dr. Evan Nadler, co-director of Children's National Medical Center's Obesity Institute. Lap band surgery can also be more easily reversed. A study co-authored by Nadler in the Journal of the American College of Surgeons showed that morbidly obese adolescents had a 45 percent excess weight loss after lap band surgery, as well as improved glucose metabolism.

Restrictions

Lap band surgery for children and adolescents can only be considered once less radical approaches to weight loss--such as diet supervision, behavior modification regimens, and exercise--have been attempted and failed, says Cincinnati Children's Hospital. Complete family support for the procedure is a must. Suitable lap band procedure candidates must also be at least six months into puberty, have a five-year history of obesity, and a Body Mass Index (BMI) measurement higher than 40, says the Driscoll Children's Hospital.

Concerns

The lap band procedure is not a cure for obesity, Nadler explains. It will not circumvent the more difficult lifestyle changes that all morbidly obese people must eventually undertake. Some pediatricians also express concern that children and adolescents do not fully understand the procedure, or how it changes their digestive system.

Specifics

According to the Lucile Packard Children's Hospital, which became the first children's hospital in California to perform lap band surgery on an adolescent in 2006, the procedure takes two to four hours to complete. Patients stay in the hospital for three to five days following surgery. Most patients are able to return to school in two to six weeks.