Gastric Balloon Non-Surgical
The Gastric Balloon, also known as the intragastric balloon, is a simple, non-surgical outpatient procedure. After you’re given a mild sedative, the physician will insert the deflated balloon through your mouth and into your stomach. It is then filled with a safe saline solution until it’s about the size of a grapefruit. The entire procedure usually only takes 20 or 30 minutes and most people go home the same day.
Types of Gastric Balloon
Many types of the gastric balloon are currently used in the endoscopic bariatric procedures. They include:
Obera Intragastric Balloon System
Orbera intragastric balloon: it is the most frequently used, and most studied intragastric balloon and were previously known as BioEnteric Intragastric Balloon. Orbera is an FDA-approved obesity treatment device that uses one balloon, placed endoscopically to induce weight loss.
ReShape Duo Gastric Balloon System
ReShape Duo Balloon: also known as “ReShape Integrated Dual Balloon System. The device is made of 2 balloons that are connected by a silicone shaft. The ReShape Duo Balloon system is an FDA-approved weight loss treatment, which is different by placing two, interconnected balloons in the stomach endoscopically.
Obalon Gastric Balloon System
Obalon Intragastric balloon: this balloon is also swallowed and then inflated with about 250mls of air. Up to three oblong balloons can be placed in the stomach. It is the first and only swallows balloon device approved by the FDA. However, at the end of 6months, the balloons are deflated and removed by endoscopy.
Spatz Gastric Balloon System
Elipse: though not FDA approved, this balloon does not require endoscopy for placement. The balloon is swallowed like a tablet under fluoroscopy guidance and subsequently inflated with saline water via the tube that is attached to it. The removal also does not need an endoscopy; the balloon spontaneously deflates after about 4months and is subsequently excreted.
How is the balloon placed in the stomach?
Under conscious sedation, the balloon is placed into the stomach by an upper gastrointestinal tract endoscope. The endoscopy tube is passed through the mouth and via the esophagus into the stomach.
Once the balloon is in the stomach, it is inflated with normal saline or air (normal saline is preferred) and left to float in the lumen of the stomach while the endoscopy tube is removed. However some of these balloons such as Elipse, Obalon do not require endoscopy for placement or removal.
How does gastric balloon work?
The mechanism of action of the gastric balloon can be likened to that of restrictive bariatric procedures. The inflated gastric balloon takes up about 80% of the capacity of the stomach leaving only 20% for food. This makes the patient feel the sense of fullness following ingestion of small amount of food.
The ultimate goal is to reduce food intake and induce weight loss. Like other bariatric procedures, it must be complemented by dietary and lifestyle modification.
The balloon is usually removed by endoscopy after 6months post-insertion. This is done to prevent injury to the wall of the stomach and to avoid in-situ degradation of the balloon.
Am I Eligible For Gastric Balloon?
Indications for gastric balloon are as follows:
- As a preemptive therapy for weight reduction in obese patients (BMI ≥ 30) at risk for disease development, at high risk for all-cause mortality, and with a high cardiovascular risk profile.
- Those with mild obesity (BMI ≥ 30 ), where recovery from metabolic disease is the primary concern may also benefit from the gastric balloon. Co-existing illnesses, such as hyperlipidemia, type II diabetes mellitus, and hypertension, could be notably improved or resolved with even a modest reduction in body weight.
- Those with a BMI > 35 with or without comorbidities, and who could not achieve long-term weight loss with a weight-control regimen.
- Patients with a BMI ≥ 40 primarily as a preparation for bariatric treatment or in patients with increased surgical risks.
- Obese patients who reject bariatric surgical procedures or who do not have an approach for surgery can also opt for it.