Gastric bypass surgery has saved the vision of a 15-year-old boy, helped him to lose 110 pounds and transformed him from an outsider to a high achiever.
"We had no choice but to act boldly and use unconventional methods," reports Prof. Eli Shahar, Director of Rambam's Pediatric Neurology Unit and Epilepsy Center, of a sleeve gastrectomy surgical weight-loss procedure performed in January 2009 by his colleague at Rambam, Dr. Ahmad Assalia, Acting Deputy Director of Department of Surgery "B" and Head of the Minimally Invasive Laparoscopic Surgery and Advanced Endoscopy Units, in order to save the deteriorating eyesight of a severely obese 15-year-old boy.
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Rambam physicians perform
sleeve gastrectomy surgery
Photo credit: RHCC
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Recently, a number of global studies have suggested a strong link between obesity and eye diseases that can result in loss of sight. This represents the first such case in Israel.
The youngster was admitted to Meyer Children's Hospital at Rambam weighing over 300 pounds, exhibiting symptoms of depression, and complaining of blurry and tunnel vision, blind spots in his field of vision, headaches and nausea.
Prof. Shahar diagnosed the teen's visual deterioration and neurological complaints, which can be symptomatic of a possible brain tumor, as in fact the result of the teen's excess pounds' having induced intracranial pressure, which in turn was interfering with blood supply to the retina. At first, the teen was given medication to decrease the intracranial pressure, but his weight interfered with the treatment's success, and all dietary attempts at weight loss failed.
Sleeve gastrectomy uses laparoscopic surgery to permanently reduce stomach size by 80%, which limits food intake and suppresses ghrelin (the "hunger hormone"). The procedure's name derives from the banana-shaped sleeve or tube that results when the reduced stomach's open ends are attached (often with surgical staples). Because active growth is still in process, the procedure is not recommended for juveniles except in severe cases where a teenager's Body Mass Index (BMI) exceeds 50 and life-threatening health problems are diagnosed.
Three weeks after the surgery, an eye exam attested to the patient's high visual acuity, and in the months following the operation, the teen lost almost 110 pounds. Dr. Assalia reports that today, the youngster has returned to his studies and is excelling after long periods of seclusion and having felt like an outsider.