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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. Lap-Band Results. First case in 2001 Ages 13-19 N=58 %EWL~50% at 1 and 2 year f/u.
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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
Lap-Band Results • First case in 2001 • Ages 13-19 • N=58 • %EWL~50% at 1 and 2 year f/u. • 2 patients with slips, 2 with hiatal hernias, 1 with appy
How Did We Get There? • Keys to Success • Patient Selection • Strict F/U Program • Compliance
Patient Selection • All patients must attend prior to meeting with the surgeon: • Group Information session • Clinical psychology evaluation • Nutritional evaluation
Patient Selection • Pre-op testing: • EKG/CXR • Bone densitometry • US Gallbladder • Nutritional lab work • F/U nutritional evaluation • PFT/Sleep study (if indicated)
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.
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.
Other Data • Band has been shown to be effective in super obese. • Obes Surg. 2005 Jun-Jul;15(6):858-63. • Preliminary data from low BMI study are encouraging. • Reduction in morbidity is comparable to GBP.
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