Bio

Bio


Dr. Janey S.A. Pratt, MD, FACS, FASMBS is a general surgeon who specializes in Robotic Hernia repair and Metabolic and Bariatric Surgery (MBS). She began her career in general surgery at Massachusetts General Hospital, where she was a founding member of the MGH Weight Center. As surgical director she introduced minimally invasive MBS and adolescent MBS to MGH in 2001 and 2007 respectively. In 2011 Dr. Pratt took over as Director at the MGH Weight Center and continued to work on several national committees towards improving access and care of adolescents with severe obesity. Dr. Pratt continued to practice general surgery through out her tenure at MGH seeing patients with breast cancer, hernias, and obesity. She performed advance minimally invasive surgery(MIS) as well as advanced endoscopy.
In 2016 Dr. Pratt moved to California where she began her work at Stanford University, splitting her time between the Lucille Packard Children’s Hospital and the Palo Alto VA. She performs Minimally Invasive MBS at both institutions as well as endoscopy. Dr. Pratt has trained in robotic surgery and performs robotic assisted hernia repairs on complex and simple hernias. As a Clinical Associate Professor of Surgery, Dr. Pratt is involved in training Stanford medical students and residents both in the OR, in the clinic, in the simulation labs and in the class room. Dr. Pratt is the associate program director of the VA MIS fellowship program, and Chair of the Pediatric Committee of the American Society for Metabolic and Bariatric Surgery.
Dr. Pratt has been involved in creating and updated guidelines for Adolescent MBS since 2005. In 2018 she was first author on the ASMBS Pediatric Metabolic and Bariatric Surgery Guidelines. Her other research interests include: MIS approaches to hernia repair and bowel obstruction, pediatric obesity treatment and the use of medications to improve outcomes of MBS. Dr. Pratt frequently lectures on the subject of Adolescent Metabolic and Bariatric Surgery.

Clinical Focus


  • General Surgery

Academic Appointments


Professional Education


  • Board Certification: General Surgery, American Board of Surgery (1999)
  • Residency:Massachusetts General Hospital (1998) MA
  • Internship:Massachusetts General Hospital (1994) MA
  • Medical Education:Tufts University School of Medicine (1993) MA

Publications

All Publications


  • National Trends in the Use of Metabolic and Bariatric Surgery Among Pediatric Patients With Severe Obesity. JAMA pediatrics Griggs, C. L., Perez, N. P., Goldstone, R. N., Kelleher, C. M., Chang, D. C., Stanford, F. C., Pratt, J. S. 2018

    View details for DOI 10.1001/jamapediatrics.2018.3030

    View details for PubMedID 30357351

  • Weight Loss Medications in Older Adults After Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multicenter Study BARIATRIC SURGICAL PRACTICE AND PATIENT CARE Stanford, F., Toth, A. T., Shukla, A. P., Pratt, J. S., Cena, H., Biino, G., Aronne, L. J. 2018
  • Weight Loss Medications in Young Adults after Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multi-Center Study. Children (Basel, Switzerland) Toth, A. T., Gomez, G., Shukla, A. P., Pratt, J. S., Cena, H., Biino, G., Aronne, L. J., Stanford, F. C. 2018; 5 (9)

    Abstract

    This paper presents a retrospective cohort study of weight loss medications in young adults aged 21 to 30 following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between November 2000 and June 2014. Data were collected from patients who used topiramate, phentermine, and/or metformin postoperatively. Percentage of patients achieving ≥5%, ≥10%, or ≥15% weight loss on medications was determined and percent weight change on each medication was compared to percent weight change of the rest of the cohort. Our results showed that 54.1% of study patients lost ≥5% of their postsurgical weight; 34.3% and 22.9% lost ≥10% and ≥15%, respectively. RYGB had higher median percent weight loss (-8.1%) than SG (-3.3%) (p = 0.0515). No difference was found in median percent weight loss with medications started at weight plateau (-6.0%) versus after weight regain (-5.4%) (p = 0.5304). Patients taking medications at weight loss plateau lost 41.2% of total body weight from before surgery versus 27.1% after weight regain (p = 0.076). Median percent weight change on metformin was -2.9% compared to the rest of the cohort at -7.7% (p = 0.0241). No difference from the rest of the cohort was found for phentermine (p = 0.2018) or topiramate (p = 0.3187). Topiramate, phentermine, and metformin are promising weight loss medications for 21 to 30 year olds. RYGB patients achieve more weight loss on medications but both RYGB and SG benefit. Median total body weight loss from pre-surgical weight may be higher in patients that start medication at postsurgical nadir weight. Participants on metformin lost significantly smaller percentages of weight on medications, which could be the result of underlying medical conditions.

    View details for DOI 10.3390/children5090116

    View details for PubMedID 30158481

  • ASMBS pediatric metabolic and bariatric surgery guidelines, 2018. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Pratt, J. S., Browne, A., Browne, N. T., Bruzoni, M., Cohen, M., Desai, A., Inge, T., Linden, B. C., Mattar, S. G., Michalsky, M., Podkameni, D., Reichard, K. W., Stanford, F. C., Zeller, M. H., Zitsman, J. 2018; 14 (7): 882–901

    Abstract

    The American Society for Metabolic and Bariatric Surgery Pediatric Committee updated their evidence-based guidelines published in 2012, performing a comprehensive literature search (2009-2017) with 1387 articles and other supporting evidence through February 2018. The significant increase in data supporting the use of metabolic and bariatric surgery (MBS) in adolescents since 2012 strengthens these guidelines from prior reports. Obesity is recognized as a disease; treatment of severe obesity requires a life-long multidisciplinary approach with combinations of lifestyle changes, nutrition, medications, and MBS. We recommend using modern definitions of severe obesity in children with the Centers for Disease Control and Prevention age- and sex-matched growth charts defining class II obesity as 120% of the 95th percentile and class III obesity as 140% of the 95th percentile. Adolescents with class II obesity and a co-morbidity (listed in the guidelines), or with class III obesity should be considered for MBS. Adolescents with cognitive disabilities, a history of mental illness or eating disorders that are treated, immature bone growth, or low Tanner stage should not be denied treatment. MBS is safe and effective in adolescents; given the higher risk of adult obesity that develops in childhood, MBS should not be withheld from adolescents when severe co-morbidities, such as depressed health-related quality of life score, type 2 diabetes, obstructive sleep apnea, and nonalcoholic steatohepatitis exist. Early intervention can reduce the risk of persistent obesity as well as end organ damage from long standing co-morbidities.

    View details for DOI 10.1016/j.soard.2018.03.019

    View details for PubMedID 30077361

  • Decreasing recurrent bowel obstructions, improving quality of life with physiotherapy: Controlled study WORLD JOURNAL OF GASTROENTEROLOGY Rice, A. D., Patterson, K., Reed, E. D., Wurn, B. F., Robles, K., Klingenberg, B., Weinstock, L. B., Pratt, J. A., King, C., Wurn, L. J. 2018; 24 (19): 2108–19

    Abstract

    To compare (1) quality of life and (2) rate of recurrent small bowel obstructions (SBO) for patients treated with novel manual physiotherapy vs no treatment.One hundred and three subjects (age 19-89) with a history of recurrent adhesive SBO were treated with a manual physiotherapy called the Clear Passage Approach (CPA) which focused on decreasing adhesive crosslinking in abdominopelvic viscera. Pre- and post-therapy data measured recurring obstructions and quality of life, using a validated test sent 90 d after therapy. Results were compared to 136 untreated control subjects who underwent the same measurements for subjects who did not receive any therapy, which is the normal course for patients with recurring SBO. Comparison of the groups allowed us to assess changes when the physiotherapy was added as an adjunct treatment for patients with recurring SBO.Despite histories of more prior hospitalizations, obstructions, surgeries, and years impacted by bowel issues, the 103 CPA-treated subjects reported a significantly lower rate of repeat SBO than 136 untreated controls (total obstructions P = 0.0003; partial obstructions P = 0.0076). Subjects treated with the therapy demonstrated significant improvements in five of six total domains in the validated Small Bowel Obstruction Questionnaire (SBO-Q). Domains of diet, pain, gastrointestinal symptoms, quality of life (QOL) and pain severity when compared to post CPA treatment were significantly improved (P < 0.0001). The medication domain was not changed in the CPA treated group (P = 0.176).CPA physical therapy was effective for patients with adhesive SBO with significantly lower recurrence rate, improvement in reported symptoms and overall quality of life of subjects.

    View details for DOI 10.3748/wjg.v24.i19.2108

    View details for Web of Science ID 000432595300006

    View details for PubMedID 29785079

    View details for PubMedCentralID PMC5960816

  • A multidisciplinary approach to laparoscopic sleeve gastrectomy among multiethnic adolescents in the United States. Journal of pediatric surgery Jaramillo, J. D., Snyder, E., Farrales, S., Stevens, M., Wall, J. K., Chao, S., Morton, J., Pratt, J. S., Hammer, L., Shepard, W. E., Bruzoni, M. 2017

    Abstract

    Childhood obesity has become a serious public health problem in our country with a prevalence that is disproportionately higher among minority groups. Laparoscopic sleeve gastrectomy (LSG) is gaining attention as a safe bariatric alternative for severely obese adolescents.A retrospective study on morbidly obese adolescents that underwent LSG at our institution from 2009 to 2017. Primary outcomes were weight loss as measured by change in BMI and percent excess weight loss (%EWL) at 1 year after surgery, resolution of comorbidities and occurrence of complications.Thirty-eight patients, of whom 71% were female and 74% were ethnic minorities, underwent LSG between 2009 and 2016. Mean age was 16.8years, mean weight was 132.0kg and mean BMI was 46.7. There were no surgical complications. Mean %EWL was 19.4%, 27.9%, 37.4%, 44.9%, and 47.7% at 1.5, 3, 6, 9, and 12month follow up visits, respectively. Comorbidity resolution rates were 100% for hypertension and nonalcoholic fatty liver disease, 91% for diabetes, 44% for prediabetes, 82% for dyslipidemia and 89% for OSA.LSG is an effective and safe method of treatment of morbid obesity in adolescents as it can significantly decrease excess body weight and resolve comorbid conditions. Further studies are needed to investigate the long-term effects of LSG in adolescents.Descriptive case series with prospective database.IV.

    View details for DOI 10.1016/j.jpedsurg.2017.06.021

    View details for PubMedID 28697852