Intra-gastric balloons – The past, present and future

Abstract

Obesity is a complex metabolic illness that is interrelated to a plethora of complications that predispose to avoidable morbidity and mortality. The considerable impact of obesity has invited various therapies ranging from lifestyle advice, pharmacotherapy, endoscopic bariatric therapy and ultimately surgery. Intragastric balloons are space-occupying therapies that aim to increase satiety through mechanical and neuroendocrine mechanisms. Their prevalence is owed to their ease of administration and general safety. However, long term data concerning safety and efficacy is scarce when considering the various types of balloons in use. In this review, we discuss the intragastric balloon comprehensively in terms of efficacy, safety, limitations and future direction.

Current Role and Potential of Polymeric Biomaterials in Clinical Obesity Treatment

“…In 2019, gastric balloons accounted for about 1.8% of the total population undergoing bariatric surgeries based on the estimate of ASMBS, providing additional opportunities for obese patients who are not eligible for RYGB or sleeve gastrectomy. As for efficacy, the most comprehensively used and studied intragastric balloon, Orbera, showcases 13.2% TBWL after 6 months of placement in humans. , However, the device needs to be endoscopically retrieved after needle aspiration of the intragastric fluid, creating inconvenience for patients . As a much less invading substitute, Elipse serves as an orally administered product that can be gradually emptied spontaneously, and the deflated device is excreted naturally through the digestive tract .…”

“…83,84 However, the device needs to be endoscopically retrieved after needle aspiration of the intragastric fluid, creating inconvenience for patients. 85 As a much less invading substitute, Elipse serves as an orally administered product that can be gradually emptied spontaneously, and the deflated device is excreted naturally through the digestive tract. 86 Elipse exhibits 12−14% of TBWL after 4 months, which seemed to be comparable to the conventional intragastric balloons.…”

The Efficacy Comparison of Endoscopic Bariatric Therapies: 6-Month Versus 12-Month Intragastric Balloon Versus Endoscopic Sleeve Gastroplasty

“…Lifestyle changes, pharmacotherapy, and diet, although widely available, seem to be insufficient for the majority of patients. At most, a 5–10% total body weight loss (TBWL) can be achieved in 50% of cases, assuming strict patient cooperation [ 2 , 3 ]. Among all procedural treatment options, bariatric surgery remains the most effective method for durable weight loss, however due to its invasiveness and the risk of early or late postoperative complications, endoscopic bariatric therapies (EBTs) may bridge the gap between conservative and surgical treatment, particularly for individuals who are not eligible for or are not willing to undergo surgery.…”

“…Their mechanism of action is multifaceted, involving physiological and neurohormonal changes. The balloons function as an artificial bezoar filling the stomach, promoting early satiety [ 3 , 7 ]. There are many different IGB types on the market, three of which have been approved by the FDA [ 4 ]: the Orbera intragastric balloon (Apollo Endosurgery, Austin, TX), the ReShape Duo (ReShape Medical, San Clemente, CA), and the Obalon IGB (Obalon Therapeutics, Carlsbad, CA).…”

“…There are many different IGB types on the market, three of which have been approved by the FDA [ 4 ]: the Orbera intragastric balloon (Apollo Endosurgery, Austin, TX), the ReShape Duo (ReShape Medical, San Clemente, CA), and the Obalon IGB (Obalon Therapeutics, Carlsbad, CA). All these models are placed into the stomach for a period of 6 months, and have well-established efficacy [ 3 ]. A meta-analysis published by the American Society for Gastrointestinal Endoscopy (ASGE) depicted that Orbera IGB resulted in an overall %TBWL of 13.16% after 6 months [ 8 ].…”