We just wrapped up a very exciting ACS conference in San Francisco this year.
 
I filled up the first two days of the conference with talks dealing with different aspects of laparoscopic surgery in the US. One of the most informational and interesting among them discussed the many dangers of using advanced direct energy devices without proper precaution and training. Surgeons mostly learn the use of ultrasonic and bipolar devices from sales representatives rather than from medical school and are therefore not properly trained in the use of these devices. Using these devices incorrectly can lead to serious patient burns as well as dangerous OR fires. The ACS panel of doctors therefore recommended comprehensive training sessions to instruct physicians on the safe use of bipolar, ultrasonic and monopolar direct energy devices in the OR.
 
The afternoon lecture discussed the benefits of bariatric surgery for adolescents. Clinical evidence demonstrates that obese children and adolescents go on to become obese adults and are at increased risk of type II diabetes, heart disease, high blood pressure and other chronic conditions. Bariatric surgery in adolescents has proved to be successful in a majority of cases preventing the onset of adult obesity. Surgeons believe that sleeve gastrectomy, which has proved to be a very effective procedure in adults, has similar potential to be the bariatric procedure of choice for adolescents as well. Lap band surgery was the traditional approach used in this patient population in the past. However, in recent times this procedure has been associated with slippage, which necessitates revisionary surgery, or band removal leading to patients regaining lost weight.  Lap band surgery also requires significant patent follow up which is particularly difficult for adolescents. Therefore sleeve gastrectomy can be expected to be the primary procedure for an expanding population of obese adolescents.
 

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