Effectiveness of intragastric balloon as a bridge to definitive bariatric surgery in the super-obese endoscopic and percutaneous interventional procedures (2017)

Type of publication:
Conference abstract

Author(s):
*Ball W.; *Raza S.S.; *Loy J.; *Riera M.; *Pattar J.; *Adjepong S.; *Rink J.; *Lyons H.; *Price B.

Citation:
Obesity Surgery; Jul 2017; vol. 27 (Supplement 1); p. 335

Abstract:
Introduction: Super Obese patients with body mass index (BMI) > 60KG/M2 pose particular difficulties for primary laparoscopic bariatric surgery. Laparoscopic port access, stapling and suturing become increasingly difficult with higher BMI. Our unit’s practice of placing an intragastric balloon for 6 months prior to definitive surgery in patients with BMI > 60KG/M2 aims to make definitive surgery less difficult by reducing weight. Objectives: To quantify weight loss after balloon placement and determine if these patients subsequently underwent definitive bariatric surgery. Methods: Retrospective review of 46 consecutive patients with intragastric balloon placement using SPSS statistical analysis on the results. Results: Median weight loss 14kg (0-42) P<0.0001, median % excess weight loss (%EWL) 15% (-3.3-64.66) P<0.001 and median BMI reduction 5KG/M2 (-1.3-13.9) P<0.001. 29/46 (63%) patients underwent definitive bariatric surgery. 10/46 (22%) patients had minor complications (nausea, vomiting and pain) requiring re-admission, of these 7/10 (70%) had early balloon removal and 6/10 (60%) did not have definitive bariatric surgery. 6/46 patients had second balloon placement median weight loss-6kg (-22-33), median %EWL-4.85% (-21.6-34.96), median BMI reduction-1.3KG/M2 (-8.5-2.5). Conclusion: Results from intragastric balloon placement are encouraging and comparable with a recent metaanalysis. Re-admissions and low %EWL with the first balloon are predictors for early balloon removal and failure to proceed to definitive surgery. Intragastric balloons as a bridge to definitive bariatric surgery are effective and safe. Sequential intragastric balloons are not recommended.