The team at Cincinnati Children's Hospital Medical Center has now completed a sleeve gastrectomy on obese pre-teen Alexis Shapiro, with plans for a more dramatic surgery derailed earlier today.
Alexis, 12, from Texas, became obese after removal of a brain tumor left her with a damaged hypothalamus and pituitary gland, prompting the incessant craving of food. The initial surgery took place two and a half years ago, with Alexis' mother Jenny estimating that her daughter has put on an average of two pounds per week ever since. Alexis has been on a strict diet and exercise program with little success, continuing to pile on the pounds and develop diabetes.
Originally, Alexis was meant to undergo two surgeries today: a gastric bypass and a vagotomy, or partial removal of the vagus nerve. The vagus nerve is thought to be instrumental in communicating cravings from the brain to the pancreas, with the process intended to supplement the physical restrictions imposed by the gastric bypass.
The surgery was live-tweeted by staff at Cincinnati Children's, who hoped to raise awareness of Alexis' condition - hypothalamic obesity - through social media. However, 50 minutes into the procedure it was tweeted that 'Alexis Shapiro's liver is larger than surgical team anticipated, making necessary visualization difficult. #HyObesity,' followed closely by 'Planned gastric bypass & vagotomy no longer safest option for Alexis today given liver size #HyObesity.' As a result, Alexis' surgical team decided to proceed with a sleeve gastrectomy, a safer procedure that will hopefully buy Alexis some time until she's able to proceed with the gastric bypass and vagotomy.
The sleeve gastrectomy reduces the size of the stomach by around 75 percent, and is irreversible. The gastric bypass is more involved procedure, where the stomach is divided into two pouches, with the small intestine attached to both. The operation is thought to have several benefits in treating morbid obesity, though physicians are still testing its efficacy.
"I'll say from the start, is we don't have enough research on the topic and we're trying to bring more understanding on how gastric bypass can work," said Dr. Thomas Inge, who is treating Alexis. "What the gastric bypass seems to do is to trick the brain that those hunger signals are not really [there.]"
