UF Health MedMatters

GI Surgeons Leverage Minimally Invasive Surgery for Pediatric Bariatric Procedures for Improved Quality of Life

In terms of solutions for weight loss, pediatric weight-loss surgery is a relatively controversial concept. In fact, only recently have societies like the American Academy of Pediatrics recognized its function as a valued treatment for children with obesity.

“People don't realize that obesity is a lifelong, progressive disease,” said Alexander Ayzengart, MD, MPH, FACS, an assistant professor in the division of gastrointestinal surgery. “Once you become severely obese, it becomes very difficult to reverse.”

When an individual’s body mass index reaches a certain point — typically between 35 to 40 — the body changes its setpoint that can affect your ability to lose weight for life, Ayzengart said.

“Then, despite everything you do, including diet, exercise and medications, your body will try and get you back to what it has deemed its ‘new normal,’” he said. “Your metabolism slows down. Hormonal changes occur that are outside your control. Behind the scenes, your body is fighting you and your attempts to lose weight.”

In cases like this, minimally invasive metabolic bariatric surgery is one of the only effective, long-term ways patients can see lasting changes — especially in a pediatric population, since surgical procedures are intended to not only improve quality of life, but prolong it.

“New research indicates that kids who are morbidly obese are inclined to stay morbidly obese for life,” Ayzengart said. “This is the first generation whose life expectancy is shorter than their parents. Consequently, academic associations are recommending surgery at a much younger age.”

As it’s done today, weight-loss surgery is significantly safer than it's ever been — largely due to the minimally invasive robotic technology at surgeons’ disposal. Ayzengart’s team conducts their own operations using a laparoscopic robotic technique, educating residents and other faculty on the appropriate use of robotic technology. The result?

Better outcomes with minimal complications.

“At this point, the mortality from weight-loss surgery is lower than that from a gallbladder operation,” Ayzengart said.

Of course, treatment for morbid obesity encapsulates more than the surgical perspective.

Pediatric patients who suffer from obesity typically present with an array of co-morbidities that can contribute to an abbreviated lifespan, such as diabetes, hypertension, sleep apnea and cancer. Accordingly, UF Health’s Bariatric Surgery Center incorporates multidisciplinary providers to address every aspect of treatment, including pediatric endocrinologists, geneticists, dietitians, psychologists, nurse educators and surgeons. Families and patients alike are educated about their preoperative behavioral and dietary changes, postoperative expectations and the long-term expectations after bariatric surgery.

“Our team not only collaborates to provide treatment, they collaborate to identify which treatment modality will make the most sense,” Ayzengart said. “We conduct an extensive workup that includes everything from genetic testing to behavioral evaluation, and dietary and lifestyle modifications.”

Nowadays, he’s seeing an increase in referrals — both internally and from external hospitals across Florida. It speaks to the unique aspects of UF Health’s program, Ayzengart said.

“We have the only truly comprehensive pediatric bariatric surgery program in the state of Florida,” Ayzengart said. “We’re multidisciplinary in our approach to evaluation and treatment. We address each aspect of the patient’s life for the best lasting outcome and improved quality of life.”

About UF Health Shands Hospital

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University of Florida Health Shands Hospital has been recognized among the nation’s best hospitals in seven adult medical specialties. Overall, UF Health Shands Hospital was recognized as one of the best hospitals in Florida. In addition to being ranked among the nation’s top 50 hospitals in seven specialties, UF Health Shands Hospital also was listed as “high performing” in seven specialties, including abdominal aortic aneurysm repair, colon cancer surgery, COPD, heart failure, lung cancer surgery, neurology & neurosurgery and orthopaedics.