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Abstracts: 2007 Poster Session / Surgery for Obesity and Related Diseases 3 (2007) 299 –344

“semi-elective” repair. Three cases are presented where more urgent treatment was warranted. Methods: Of the initial 464 LAGBs placed by one surgeon practicing in an academic center there were 29 (6.3%) cases of gastric prolapse requiring re-operation. Two patients “slipped” twice and one patient had three gastric prolapses. All were repaired laparoscopically. Results: Three patients (0.6%) had presentations that were atypical. Although each had heartburn and vomiting, they also complained of intense abdominal pain. Exam was significant for pain out or proportion to physical findings. All had laparoscopic exploration converted to laparotomy due to necrosis and/or perforation of the herniated stomach. A resection followed. Conclusion: Ischemic necrosis of the prolapsed fundus is rare following LAGB. Patients complaining of abdominal pain especially out of proportion to physical findings should be suspected of having ischemia of the stomach and warrant more urgent repair of their prolapse. PII: S1550-7289(07)00308-5

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NORMALIZATION OF EATING BEHAVIOR AS A RESULT OF LAPAROSCOPIC BANDING SURGERY. Adam Smith, DO; Susan Franks, PhD; Joan Carroll, PhD1 Laproscopy, Bariatrics, and Surgery (LBS), Fort Worth, TX; 1University of North Texas Health Science Center, Fort Worth, TX Background: Virtually all individuals who present to bariatric clinics as candidates for bariatric surgery are life-long dieters and have experienced the perpetual weight gain-weight loss cycle associated with maladaptive eating patterns. Further, it is thought that there is a positive relationship between weight-cycling and binge eating which is common among bariatric patients. Although it is intuitive that eating behavior is a critical part in the puzzle of bariatric surgical outcome, it is not clear how eating behaviors may vary according to surgical intervention. Thus, the purpose of this study was to examine the effect of laparoscopic banding surgery (LBS) on patterns of eating behavior in morbidly obese patients. Methods: Subjects included 28 morbidly obese patients (MO) and 30 age-matched normal weight controls (NW). Prior to (T1) and 6-months after placement of a laparoscopic adjustable gastric band (LAGB), (T2), MO were assessed for eating behavior patterns using The Eating Inventory. Results: At T1, MO and NW significantly differed in Cognitive Restraint (7.6⫾4.3 vs. 11.5⫾5.0, p⫽.0001 respectively), Disinhibition (11.2 ⫾3.1 vs. 4.0⫾3.0, p⫽0.0001, and Hunger 8.7⫾3.2 vs. 4.1⫾3.1, p⫽0.0001. LAGB resulted in significant changes in eating behaviors from T1 to T2: Cognitive Restraint (7.6⫾4.3 vs. 14.1⫾3.6, p⫽.0001 respectively), Disinhibition (11.2⫾3.1 vs. 6.2 ⫾3.4, p⫽0.0001, and Hunger 8.7⫾3.2 vs. 3.7⫾2.9, p⫽0.0001. The pattern of eating behaviors at T2 was not significantly different from NW. Conclusion: Thus, LAGB appears to normalize eating patterns and consequently provide patients with an effective mechanism for sustained weight loss. PII: S1550-7289(07)00309-7

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LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING (LAGB) IN OBESE ADOLESCENTS: SHORT-TERM RESULTS. Mary Ann Witt, DNSc(c); Ilene Fennoy, MD, MPH; Amy M Jean, MD; Jeffrey L Zitsman, MD Morgan Stanley Children’s Hosp of NY Presbyterian, New York, NY Background: Obesity among US adolescents has reached epidemic proportions; 15.5% are ⬎ 95th %tile for body mass index (BMI). A small number of studies show LAGB is safe and effective in treating morbidly obese (MO) adolescents. We received FDA approval to test the safety and efficacy of LAGB within a multidisciplinary weight management program for 15 MO adolescents (ages 14-17) as a pilot study. Methods: We reviewed our prospectively collected database for adolescents who underwent LAGB at our Center. Preoperative data included age, gender, ethnicity, BMI, comorbidities, physical fitness level and prior activity level. Post-operatively data included percent excess weight loss (% EWL) and BMI, length of stay, operative morbidity, post-operative complications, and status of pre-operative comorbidities. Results: Fifty-six adolescents have been screened. Five patients (1 male, 4 females) aged 14-17 (mean⫽ 16.5) have undergone LAGB. Baseline comorbidities include HTN (n⫽ 2); impaired fasting glucose (n⫽2); PCOS (n⫽1); irregular periods (n⫽2); hypertriglyceremia (n⫽2); depression/anxiety disorder (n⫽4). There were no operative complications. Patients were discharged within 24 hours. One patient complained of diarrhea for 5 days that resolved without treatment. Baseline HTN and impaired fasting glucose resolved 1 week after surgery (n⫽1). Change in physical activity/fitness level has not yet been analyzed. Conclusion: Short-term results suggest LAGB is safe and effective in treating MO adolescents. N

weeks post-op

Wt loss(kg)

BMI kg/m2

2BMI

1 3 1

2 8 10

4.6 13.1* 34.3

42.6 38.2* 38.9

21.6 25.2* 28.9

* expressed as means

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SLEEVE GASTRECTOMY AS A REVISION PROCEDURE FOR FAILED BARIATRIC OPERATIONS: EXPERIENCE WITH 21 CASES. Leon D Cohen Mercy Bariatrics, Perth, WA Australia Background: Sleeve Gastrectomy is now recognized as a valid revision option for failed bariatric surgery. From October 2003 to October 2006 we have revised 21 patients from prior bariatric operations using this technique. Methods: Cases included ,18 laparoscopic adjustable bands, 2 fixed bands and 1 VBG. Nineteen of these operations were performed laparoscopically and 2 open, where facilities for advanced laparoscopic surgery were not available. Three of the lap bands had been previously removed. Two of the eroded bands where revised at the time of band removal. Reasons for revision include band intolerance 7, chronic slippage 6 , pseudoachalasia 3 , band erosion 2, explantation of port 2,