March 21, 2014 -- Doctors at the Cincinnati Children’s Medical Center were unable today to give a 12-year-old girl weighing over 200 pounds a full gastric bypass after they found her liver was too large during the operation.
Instead of the full gastric bypass, Alexis Shapiro, 12, who suffers from a rare condition called hypothalamic obesity that leaves her always feeling hungry, had a sleeve gastrectomy, that will reduce her stomach to about 25 percent of its original size.
The girl's symptoms started in 2011 after the removal of a benign brain tumor resulted in damage to Alexis' pituitary gland and an area in the hypothalamus part of her brain, which affects how her body perceives signals from her digestive system.
Dr. Thomas Inge, a surgeon and professor of surgery and pediatrics at Cincinnati Children's Hospital Medical Center in Ohio, said Alexis’ has gained so much weight it enlarged her liver which meant they could not perform a full gastric bypass. Doctors were able to move part of her liver to perform the sleeve gastrectomy.
Inge said they will see how the teen fares and how much weigh she loses after this initial operation before they decide if they will do a full gastric bypass that would further shrink her stomach.
"What our intent was in offering the bypass is to treat more potently this very biological form of obesity that Alexis suffers from,” said Inge. "Long term it remains to be seen if this sleeve will help her get to the weight she wants to be at."
Inge said this type of weight loss surgery will likely help to shrink Alexis’ liver and help her lose weight, so that a full gastric bypass will be possible in the future.
In addition to the planned gastric bypass operation, an additional procedure to remove part of Alexis’ vargus nerve, which is thought to transmit powerful signals from the brain to the pancreas, was aborted as well today.
Inge said the nerve located behind the liver could not be safely reached. Inge said in spite of the setback they were happy with the outcome.
"It’s not disappointing at all," said Inge. "Our goal here is to do a safe operation under circumstances that are not 100 percent predictable."
Alexis is currently in critical but stable condition.