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

2. 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

3. How Did We Get There? Keys to Success –Patient Selection –Strict F/U Program –Compliance

4. 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.

7. 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.

8. Compliance OR6M12M18M2Y3Y 5829/38 (76%) 18/23 (78%) 6/7 (86%) 5/5 (100%) (4/4) (100%)

9. 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.

10. THANK YOU. QUESTIONS?