Advances in endoscopic balloon therapy for weight loss and its limitations

Abstract

The field of medical and surgical weight loss is undergoing an explosion of new techniques and devices. A lot of these are geared towards endoscopic approaches rather than the conventional and more invasive laparoscopic or open approach. One such recent advance is the introduction of intrgastric balloons. In this article, we discuss the recently Food and Drug Administration approved following balloons for weight loss: the Orbera™ Intragastric Balloon System (Apollo Endosurgery Inc, Austin, TX, United States), the ReShape® Integrated Dual Balloon System (ReShape Medical, Inc., San Clemente, CA, United States), and the Obalon (Obalon® Therapeutics, Inc.). The individual features of each of these balloons, the method of introduction and removal, and the expected weight loss and possible complications are discussed. This review of the various balloons highlights the innovation in the field of weight loss.

Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss

“…The initial phase of the REDUCE Pivotal trial demonstrated that gastric ulcers occur frequently in these patients but usually do not cause important bleeding complications [5]. Patients who undergo IGB insertion need careful follow-up post insertion and systematic reporting to determine complication rates [6,7]. Additionally, these balloons should not stay in place for more than six months, and patients should be educated about regular follow up.…”

Use of Intragastral Balloon and Increase in Fertility: Case Report

“…Three intragastric balloon devices are currently approved by the FDA in the United States: Orbera Intragas Balloon System (Apollo Endosurgery Inc, Austin, TX, United States), ReShape® Integrated Dual Balloon System (ReShape Medical, Inc., San Clemente, CA, United States), and Obalon (Obalon® Therapeutics, Inc.). These devices are indicated for patients with Class 1 and 2 obesity (BMI 30-40 kg/m 2 ) [2].…”

“…Once this is achieved, the catheter is used to inject gas (mixture of nitrogen-sulfur hexafluoride) into the flask. Each flask has a volume of approximately 250 mL, totaling 750 mL with 3 flasks [2].…”

“…The Orbera Intragastric Balloon and the Reformed Integrated Double Balloon are placed in the gastric cavity through the mouth through a gastroscope. The Obalon balloon is swallowed by the patient through guided fluoroscopy and endoscopy is required to remove the balloon [2].…”

Overview of bariatric and metabolic endoscopy interventions

“…The dual balloon design reduces the risk of prosthesis migration and is retrieved 6 months after placement. 22 The REDUCE pivotal trial was a prospective, randomized controlled trial published in 2015 that was conducted to evaluate the safety and efficacy of the Reshape procedure. Patients undergoing the procedure were found to have a decreased 25.1% %EWL compared with 11.3% for the control group (intention-to-treat).…”