Intragastric Balloon for Overweight Patients

• Published in: Journal of the Society of Laparoendoscopic Surgeons 2016-01, Vol.20 (1), p.e2015.00107
• Main Authors: Martins Fernandes, Jr, Flavio Augusto, Carvalho, Gustavo L, Lima, Diego L, Rao, Prashanth, Shadduck, Phillip P, Montandon, Isabelle D, de Souza Barros, Juscielle, Rodrigues, Ingrid Lais Vieira
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bariatric Surgery - instrumentation; Body Mass Index; Equipment Design; Female; Follow-Up Studies; Gastric Balloon; Humans; Male; Middle Aged; Obesity, Morbid - surgery; Prospective Studies; Scientific Patients; Treatment Outcome; Weight Loss
• ISSN: 1086-8089; 1938-3797
• DOI: 10.4293/JSLS.2015.00107

Current treatments for overweight adults include reduced-calorie diet, exercise, behavior modification, and selective use of medications. Many achieve suboptimal results with these measures and progress to obesity. Whether the intragastric balloon (IGB), a reversible device approved for treatment of obesity, is a safe and effective option in overweight adults is less well studied. We conducted a study to prospectively analyze the safety and effectiveness of IGB in overweight adults, to compare the results to a simultaneously studied cohort of obese patients, and to share procedural tips for safe IGB placement and removal. One hundred thirty-nine patients were evaluated in this prospective, nonrandomized study. Twenty-six overweight [body mass index (BMI), 26-30)] and 113 obese (BMI > 30) patients underwent outpatient, endoscopic IGB placement under intravenous sedation. The IGB was filled with a 550-900 mL (average, 640 mL) solution of saline, radiological contrast, and methylene blue, with an approximate final proportion of 65:2:1. The patients were followed up at 1-2 weeks and then monthly for 6 months. At 6 months, they underwent IGB removal via an esophageal overtube to optimize safety, and then they were observed for 6 more months. IGB time was 190 ± 36 d in the overweight patients and 192 ± 43 d in the obese patients. Symptoms of IGB intolerance included nausea and pain, which were transiently present in 50-95% of patients for several days, and necessitated early IGB removal in 6% of patients. There were no procedure-related complications and no IGB-related esophagitis, erosion, perforation, or obstruction. The percentage of excess weight loss (EWL%) was 96 ± 54% in the overweight group and 41 ± 26% in the obese group (P < 0.001). In overweight adults failing standard treatments, IGB placement for 6 months had an acceptable safety profile and excellent weight loss.