Pediatric Laparoscopic Sleeve Gastrectomy

Laparoscopic sleeve gastrectomy is a minimally invasive weight-loss surgery in which approximately 75–80% of the stomach is removed, leaving behind a narrow, tube-shaped “sleeve.” The smaller stomach holds less food, helps patients feel full more quickly and reduces hunger hormone production. This procedure is safe and effective in pediatric patients, with minimal impact on long-term growth, development or nutritional status when performed in a comprehensive, high-volume pediatric center.

Our weight-loss program is about more than just surgery. We provide intensive pre-and post-operative care. Before your child’s surgery, you can expect:

• Candidacy evaluation. We believe all children suffering from obesity can be a candidate for sleeve gastrectomy, but there may be some medical or other issues to deal with first. Your child will need to complete an evaluation and possibly diagnostic testing prior to any surgery.
• Weight-loss clinic. Your child will likely need to be seen in our Obesity Program (IDEAL Clinic). There, they learn about the behavioral modifications they will need to use after the surgery, such as choosing healthy foods and eating smaller portions. If you do not live locally, we can recommend hospitals in your area where your child can complete this part of the process.  The number of visits to the IDEAL clinic is often dictated by your insurance company and not by our providers.

On the day of the surgery, here is a general idea of what you can expect. We will:

1. Administer general anesthesia by a pediatric anesthesiologist. Your child will be asleep during the procedure and not feel any pain.
2. Make five small incisions in the abdomen to insert ports. The surgeon will insert the laparoscope (a thin camera) and the surgical instruments through the ports. The camera is attached to a video monitor, which the surgeon looks at to see real-time images of the operating site.
3. Remove about 80-90% of the stomach. This creates a vertical, banana-shaped pouch. No intestines are bypassed or rerouted.
4. Remove the instruments and close the incisions with stitches. The procedure takes between 60 and 90 minutes.

The smaller pouch fills up quickly, limiting the amount of food your child can eat. This leads to weight loss. There are also metabolic benefits to removing the large portion of the stomach.

Our care does not end when the surgery is over. Our Bariatric Surgery Program includes an intensive post-surgical support system. We follow up with our patients frequently, more often than in an adult bariatric surgery program. Generally, the schedule of follow-up visits is:

• Two to three weeks after the surgery
• Every three months during the first year
• Every six months during the second year
• Every year during the third year and beyond
• Visits in the IDEAL Clinic alternating with visits to the surgery clinic

For more information, call 202-476-2151.