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Intragastric Balloon, an Endoscopic Weight Loss Technique

 

Obesity is a major problem of modern society and the number of cases in our country, as well as abroad, is alarmingly increasing. Overweight and obesity frequently associate with an “ugly” self-image and with an echo on social, affective and professional life.

The intragastric balloon is recommended to people with a body mass index in the 27 to 40 range – overweight and I and II degree obesity (i.e. people who do not qualify for the surgical treatment of obesity), who did not manage to lose weight by diet and physical exercise. Furthermore, it may be recommended in morbid obesity cases, before surgical intervention, in order to decrease surgical risk (helps control pathologies relating to obesity – high blood pressure, diabetes mellitus, sleep apnea syndrome etc.).

The endoscopic installation of the intragastric balloon is a non-surgical weight loss method recommended as an alternative to those who target a period of intense weight loss and who understand they need to keep a correct, long-term eating and movement regime.

The intragastric balloon is a soft silicone balloon resistant to gastric acid; it triggers weight loss by partially occupying the stomach in a way that decreases appetite and accelerates the feeling of satiety.

Introduction of the balloon

The balloon is inserted by the gastroenterologist with an anesthetist and a medical assistant qualified in therapeutic endoscopy; it lasts 15 minutes on average.

Depending on the patient’s degree of obesity and related diseases, sedation and analgesia or general anesthesia with intubation will be chosen.

After the intervention, the patient is monitored for a few hours by qualified personnel and he/she can return home or can remain under 24-hour supervision, in order to note any potential adverse reaction that may appear in the first 2 to 6 days after the insertion: nausea, abdominal cramping triggered by the adaptation of the stomach to the presence of the balloon.

Extraction of the balloon

This intervention occurs 6 to 8 months later, usually under sedation and analgesia. The procedure lasts 15 minutes. The endoscope is inserted in the stomach, the device has a canal on which a needle attached to a plastic tube is inserted; the balloon is punctured and the balloon liquid is extracted. The balloon is then removed from the stomach with a special clamp which is inserted along the endoscope therapy canal. The extraction procedure does not require the patient’s supervision after the extraction; the patient is free to return home immediately.

The insertion of the gastric balloon is the first part of a programme in which the patient is monitored by a multi-disciplinary team made from gastroenterologist, nutritionist and perhaps psychologist.

The programme

Before the procedure, a consultation with the gastroenterologist is necessary, to evaluate the balloon indications and potential contraindications. Evaluation of the degree of obesity, of its causes; the patient is explained the benefits and risks of the intervention and how it will take place. Routine serum tests, and perhaps an electrocardiogram and a chest radiography will be indicated. Later, the patient will be scheduled for the balloon insertion intervention.

Results

The weight loss is proportional with the patient’s motivation and the quality of following the diet. Weight loss ranges between 10 and 25 kg in the period in which the balloon is in the stomach. Weight loss will continue to occur after the extraction of the balloon only depending on how the changes of the lifestyle are followed on the long term. For this reason it is important to follow the diet after the ablation of the balloon, in order to continue to lose weight or to stabilize weight.

The major result of the 6 months during which the gastric balloon was kept inserted is a positive change in body image, by weight loss, as well as a change of the eating behavior, which gives to the patient the satisfaction and the desire to maintain the newly acquired balance.

 

source: Metropolitan Hospital Marketing & Communication Dept., May 2016