NYU Adolescent Bariatric Surgery Followup Program

1
NYU Adolescent Bariatric Surgery Follow-up
Program

• Evan P. Nadler, MD
• Director of Minimally Invasive Pediatric Surgery
• Assistant Professor of Surgery
• New York University School of Medicine

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Lap-Band Results

• First case in 2001
• Ages 13-19
• N58
• EWL50 at 1 and 2 year f/u.
• 2 patients with slips, 2 with hiatal hernias, 1
  with appy

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How Did We Get There?

• Keys to Success
• Patient Selection
• Strict F/U Program
• Compliance

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Patient Selection

• All patients must attend prior to meeting with
  the surgeon
• Group Information session
• Clinical psychology evaluation
• Nutritional evaluation

5
Patient Selection

• Pre-op testing
• EKG/CXR
• Bone densitometry
• US Gallbladder
• Nutritional lab work
• F/U nutritional evaluation
• PFT/Sleep study (if indicated)

6
Follow-up Program

• Patients are seen 1-2 week, 6 weeks, 3 months, 6
  months, 9 months, 12 months, and every 6 months
  thereafter.
• Subjects are weighed and given a physical
  examination at each visit.
• Parents and subjects will meet with the
  nutritionist at these same visits. 
• Psych visit every 6 months.

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Follow-up Program

• Weight loss starts around 3 months post-op.
• Goal is 1-2 lbs per week.
• If they lose weight too quickly develop symptoms
  such as heartburn, nausea, vomiting or
  overeating or develop a condition or illness
  requiring them to eat more, they will be
  evaluated for removal of fluid from the band. If
  they lose weight too slowly or overeat, they will
  be evaluated for addition of fluid to the band.

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Compliance
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Other Data

• Band has been shown to be effective in super
  obese.
• Obes Surg. 2005 Jun-Jul15(6)858-63.
• Preliminary data from low BMI study are
  encouraging.
• Reduction in morbidity is comparable to GBP.

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THANK YOU.

• QUESTIONS?