A doctor at New York University Medical Center has raised concerns that the facility is rushing through too many lap band surgeries and not providing enough follow-up care after the operations are performed.
Dr. Neelu Pal is not alone in having concerns: many doctors who specialize in helping obese patients are questioning the long-term effectiveness and safety of lap band surgery, especially when it is performed on teenagers.
- A gastric band is an inflatable band made of silicon that a surgeon clamps around the top of the stomach to create a small pouch that restricts the patient's intake of food.
- Only a few studies have been done on the long-term effectiveness of the surgery as performed on teenagers.
- One such study found that 20% of teenagers experience "pouch dilation," which means the pouch gets bigger and allows too much food intake.
- A Swiss study of adults published in the journal Obesity Surgery found that the band fails 33% of the time within ten years, and one in five patients need a second surgery.
Mary Brandt is an investigator for a government study called Teen Longitudinal Assessment for Bariatric Surgery.
"Bands are definitely safe in the short term and definitely work in the short term," she said."What we don't know is about the long-term. I think there is a fundamental problem with putting a rigid plastic object around a moving organ. ... You're asking it to stay in place and not erode over a long period of time. ... I'll be happy to reverse my position as soon as I see ten or 20-year data."
Dr. Pal raised concerns that the NYU facility was performing as many as 20 lap band surgeries a day. "I could see what they were trying to do was get as many patients onto the operating table as possible," she said. The death of a 14-year-old boy who died of infection after a surgery at NYU is currently under litigation.
Lap band surgery does not address the problem that most patients eat for emotional reasons, including undiagnosed depression. A recent small study indicated that the majority of patients who underwent lap band surgery develop problems with substance abuse.
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