Preoperative weight reduction using the intragastric balloon

Abstract

Background: Gastric balloon therapy (GBT) is a temporary, nonsurgical treatment for obesity. This retrospective study evaluates safety and efficacy of GBT in obese patients.

Methods: The BioEnterics. Intragastric Balloon (BIB) was endoscopically implanted into each patient's stomach and inflated with saline (450-750 ml). Extraction was planned after 6 months. Data from 190 patients receiving GBT were evaluated. Mean weight was 168.4 +/- 58.9 kg (range 76.5-310.0) and mean BMI was 55.6 +/- 17.5 kg/m2 (range 27.0-95.7).

Results: Mean weight loss at the time of balloon removal was 21.2 +/- 14.0 kg (range 0-80.0). The mean BMI loss and EBL(Excess BMI Loss) were 7.2 +/- 4.9 kg/m2 (range 0-28.9) and 30.1 +/- 26.4% (0-184.4), respectively. The most substantial weight and BMI loss was observed in the most massively obese patients. Minor complications at implantation were encountered in 2 cases (1.1%) due to leakage of the balloon, and in 3 cases at explantation (1.6%). No mortality or major complications such as gastric perforation or ulcers occurred. Of the 190 patients, 76 received subsequent surgery (40.0%). Of those, 7 patients had a BMI < 50 kg/m2 while all other patients where super-obese (BMI > 50 kg/m2). 58 patients (30.5%) with a BMI > 60 kg/m2 which had an extraordinary high operation risk were able to receive subsequent surgical treatment because of a substantial weight loss and/or reduced comorbidity.

Conclusion: GBT appears to be a safe, tolerable, and potentially effective procedure for the initial treatment of morbid obesity.

Fig. 1

Presentation of the BioEnterics Intragastric Balloon (BIB). The balloon was filled with saline solution to a volume of 600 ml. The radiopaque, self-sealing valve (dark) can be seen on top. Note that the BIB is implanted deflated into the patient's stomach and filled subsequently.

Fig. 2

Percentage of patients receiving subsequent surgery.