The Intragastric Balloon – Smoothing the Path to Bariatric Surgery

Melissas, John; Mouzas, John; Filis, Dimetrios; Daskalakis, Markos; Matrella, Erminia; Papadakis, John A.; Sevrisarianos, Nikos; Charalambides, Demetris

doi:10.1381/096089206777822188

Cited by 80 publications

(51 citation statements)

References 24 publications

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“…It can be used as temporary method to aid in weight reduction, for example, as a first-stage treatment of high-risk super-obese patients in need of surgical intervention or in patients who refuse bariatric surgery (27,28). At this moment, the Roux-en-Y gastric bypass ( Fig.…”

Section: Surgical Treatment Of Obesity: Bariatric Surgerymentioning

confidence: 99%

Surgical treatment of obesity

Bult¹,

Dalen²,

Müller³

2008

European Journal of Endocrinology

229

141

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More than half of the European population are overweight (body mass index (BMI) O25 and !30 kg/m 2 ) and up to 30% are obese (BMIR30 kg/m 2 ). Being overweight and obesity are becoming endemic, particularly because of increasing nourishment and a decrease in physical exercise. Insulin resistance, type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, certain forms of cancer, steatosis hepatis, gastroesophageal reflux, obstructive sleep apnea, degenerative joint disease, gout, lower back pain, and polycystic ovary syndrome are all associated with overweight and obesity. The endemic extent of overweight and obesity with its associated comorbidities has led to the development of therapies aimed at weight loss. The long-term effects of diet, exercise, and medical therapy on weight are relatively poor. With respect to durable weight reduction, bariatric surgery is the most effective long-term treatment for obesity with the greatest chances for amelioration and even resolution of obesity-associated complications. Recent evidence shows that bariatric surgery for severe obesity is associated with decreased overall mortality. However, serious complications can occur and therefore a careful selection of patients is of utmost importance. Bariatric surgery should at least be considered for all patients with a BMI of more than 40 kg/m 2 and for those with a BMI of more than 35 kg/m 2 with concomitant obesity-related conditions after failure of conventional treatment. The importance of weight loss and results of conventional treatment will be discussed first. Currently used operative treatments for obesity and their effectiveness and complications are described. Proposed criteria for bariatric surgery are given. Also, some attention is devoted to more basic insights that bariatric surgery has provided. Finally we deal with unsolved questions and future directions for research. European Journal of Endocrinology 158 135-145

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Section: Surgical Treatment Of Obesity: Bariatric Surgerymentioning

confidence: 99%

Surgical treatment of obesity

Bult¹,

Dalen²,

Müller³

2008

European Journal of Endocrinology

229

141

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“…Previously published results revealed an average weight loss of 12-15 kg over 6 months with an excellent safety profile [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] . The Spatz Adjustable balloon was introduced in 2010 as the first IGB approved for 1 year implantation while featuring an adjustability function that afforded balloon volume changes as needed.…”

Section: Introductionmentioning

confidence: 99%

One year adjustable intragastric balloon: safety and efficacy of the Spatz3 adjustable balloons

Machytka

Brooks²,

Bužga

et al. 2014

F1000Res

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Discuss this article AbstractThe Spatz3 Adjustable balloon system is approved for 1 year Background: implantation and allows multiple changes in the balloon volume during the course of implantation. Other intragastric balloons are currently approved for 6 months and their balloon volumes cannot be adjusted after implantation.To determine the efficacy and safety of the Spatz3 adjustable balloon Aim: system.Seventy seven consecutive patients (66 females and 11 males) in Methods: two medical centers were implanted with the Spatz3 adjustable balloon device and were followed prospectively. The patients' mean BMI was 37.2; the mean weight was 108.7 kg; the mean age was 41 (16-68); the mean balloon volume was 469 ml (450-500 ml). Adjustments were made for intolerance or weight loss plateau.The mean weight loss at 1 year was 17.2 kg with 15.9 % weight loss Results: and 42.9 % Excess Weight Loss (%EWL). Eighteen patients underwent balloon volume adjustments: three downward adjustments of 100 -150 cc which alleviated early intolerance; 15 upward adjustments (mean 320 ml; range 200-500) at a mean 4.1 months (range 2-5 months) yielded additional mean wt loss of 8.2 kg (range 0-25 kg) after the adjustment. Three balloons were removed before the 1 year completion date due to intolerance and three others were removed for other reasons (pregnancy, gall bladder surgery, and alcoholism). There was one episode of gastric ulceration which required endoscopic therapy and balloon removal. There were no deflations or perforations.The Spatz3 adjustable balloon is a safe and effective treatment Conclusions: for weight loss. The adjustability function can yield greater weight loss for those who show weight loss plateau and can mitigate intolerance.

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“…Only very few studies have been published regarding this topic (22,30,40,41), but these are heterogeneous, and some of them have been conducted in populations with extreme obesity (super-obese) who are not representative of the overall group of patients with morbid obesity.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of an intra-gastric balloon before bariatric surgery

et al. 2017

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Introduction: There are only few reports regarding the use of intragastric-balloons (IGB ® ) to achieve weight loss and subsequently decrease surgical complications. In this study, we try to assess whether presurgery weight loss using IGB decreases the postsurgical mortality after bariatric surgery.Material and methods: This is a prospective case-control study. We matched 1:1 by gender, age (± 10 y-o) and type of surgery (sleeve resection [LSG] or gastric bypass [LGBP]), matching cases (A) and controls (H, from a historic cohort). Morbidly obese patients with an indication for bariatric surgery were included in the study. Cases (A) were recruited from an ongoing clinical trial, and the controls (H) came from a historic cohort prior to the start of the clinic trial. The presurgical weight loss in group A was reached by IGB combined with diet, versus only diet in group H.Results: We included 58 patients, 65.5% women, 69% LGBP/31% LSG. The mean age of group A was 42 and 43.4 years old for group H. ASA III of 24.1% group A vs 58.6% group H, p = 0.012. The mean total weight loss (TWL) before surgery was greater in group A (16.2 kg, SD 9.75) than in group H (1.2 kg, SD 6.4), p < 0.0001. The % of EWL before surgery was 23.5 (SD 11.6) in group A vs 2.4 (SD 8) in group H, p < 0.001. Hospital stay was seven days for group A, and eight days for group H, p = 0.285. The rate of unsuccessful IGB treatment to accomplish the scheduled weight loss was 34.5%. The balloon morbidity was 17.2% (6.9% severe). All in all, morbidity (due to bariatric surgery and IGB) was 41% in both groups. Postsurgical morbidity moderate-severe was 20.3% in group A (6.9% severe) and 27.3% in group H (17.2% severe) without statistical significance. One patient died in group H (mortality rate, 3.44%).Conclusion: Preoperative IGB treatment in morbid obesity has not been found to be effective at decreasing postsurgical morbidity LSG and LGBP, despite the fact that it acheives a greater weight loss than diet and exercise.

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The Intragastric Balloon – Smoothing the Path to Bariatric Surgery

Cited by 80 publications

References 24 publications

Surgical treatment of obesity

Surgical treatment of obesity

One year adjustable intragastric balloon: safety and efficacy of the Spatz3 adjustable balloons

Usefulness of an intra-gastric balloon before bariatric surgery

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