Bariatric Surgery Rated First in U.S.

Drs. Fielding and Ren hold the lap-band surgical weightloss device that is changing the lives of thousands of obese patients at NYU Medical Center.

When people try to shed pounds, they tend to focus on the width of their waists. But when bariatric surgeons at NYU Medical Center help the morbidly obese take control of their weight, they are more concerned with the width of their patients’ stomach openings. Using a device called a Laparoscopic Adjustable Gastric Band, or lap-band for short, the doctors reduce the size of the opening. By restricting the amount of food that can enter, the lap-band tricks the stomach into feeling full, so the patient eats much less and drops excess weight at a healthy rate.

The lap-band device received Food and Drug Administration approval for use in the United States in 2001. Since then, the NYU Program for Surgical Weight Loss has become a leader in the surgical procedure to install the silicon ring device around the upper portion of patients’ stomachs. In a national ranking of major teaching hospitals, The University Healthcare Consortium recently named the NYU program Best Performer in Bariatric Surgery.

The program is headed by Christine Ren, M.D., Assistant Professor of Surgery, and George Fielding, M.D., Associate Professor of Surgery, who recently joined NYU from Wesley Hospital in Brisbane, Australia. The doctors are the world’s most experienced surgeons with the lap-band procedure. Dr. Fielding not only developed the technique that is presently used to implant the lap-band, but is himself a former patient. The deceptively simple-looking lap-band—resembling a piece of calamari in both shape and texture—has transformed the lives of over a thousand NYU patients, among them Kahliah Ali, Muhammad Ali’s daughter.

The lap-band procedure, says Dr. Fielding, is quickly replacing the previous standard: gastric bypass, in which the surgeon makes a large incision across
the abdomen, then cuts away the stomach and reshapes a piece of it into a small pouch. In the lap-band procedure, the surgeon uses incisions just a few inches across, and the stomach is not cut. The advantage, explains Dr. Ren, is that the lap-band procedure is reversible, adjustable, safer, has a shorter recovery period, and does not have the risk of nutritional deficits associated with gastric bypass.

Lap-band, unlike gastric bypass, is also considered safe for severely obese adolescents. Dr. Fielding is beginning to perform this surgery on overweight teenagers with associated major health problems. Adolescent patients will first undergo assessment by the NYU Child Study Center, and their bariatric care will be performed in collaboration with Evan Nadler, M.D., Assistant Professor of Pediatric Surgery and Director of Minimally Invasive Pediatric Surgery