Obesity Surgery

, 18:1611

Evidence-based Review of the Bioenterics Intragastric Balloon for Weight Loss

Review

Abstract

We reviewed clinical studies performed with the Bioenterics intragastric balloon (BIB) to promote weight loss. Thirty studies were included [18 prospective (5 randomized), 12 retrospective], totaling 4,877 patients. Only one of three sham-controlled trials found a significantly higher weight loss with the BIB vs the sham procedure plus exhaustive follow-up. In nonrandomized studies, weight loss with the BIB averaged 17.8 kg (range, 4.9–28.5), corresponding to BMI changes of 4.0–9.0 kg/m2. Comorbidities resolved or improved in 52–100% of patients. Best short-term results were observed in patients devoid of binge eating disorder with a BMI in the 30.0–40.0 kg/m2 range; the BIB also helped to prepare superobese patients for bariatric surgery. Severe complications were exceptional (gastric perforation and intestinal obstruction; 0.2% each); digestive intolerance prompted early BIB removal in 2.5% of patients. Long-term (≥2 years) results are awaited, as well as well-designed studies to define the best indications for this therapy.

Keywords

Obesity Gastrointestinal endoscopy Gastric balloon Weight loss 

Abbreviations

BMI

body mass index

BIB

Bioenterics intragastric balloon

References

  1. 1.
    Schapiro M, Benjamin S, Blackburn G, et al. Obesity and the gastric balloon: a comprehensive workshop. Tarpon Springs, Florida, March 19–21, 1987. Gastrointest Endosc. 1987;33:323–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Forestieri P, De Palma GD, Formato A, et al. Heliosphere bag in the treatment of severe obesity: preliminary experience. Obes Surg. 2006;16:635–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Mion F, Gincul R, Roman S, et al. Tolerance and efficacy of an air-filled balloon in non-morbidly obese patients: results of a prospective multicenter study. Obes Surg. 2007;17:764–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Gaggiotti G, Tack J, Garrido AB, Palau M, Cappelluti G, Di Matteo F. Adjustable totally implantable intragastric prosthesis (ATIIP)-Endogast for treatment of morbid obesity: one-year follow-up of a multicenter prospective clinical survey. Obes Surg. 2007;17:949–56.PubMedCrossRefGoogle Scholar
  5. 5.
    Al-Momen A, El-Mogy I. Intragastric balloon for obesity: a retrospective evaluation of tolerance and efficacy. Obes Surg. 2005;15:101–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Alfalah H, Philippe B, Ghazal F, et al. Intragastric balloon for preoperative weight reduction in candidates for laparoscopic gastric bypass with massive obesity. Obes Surg. 2006;16:147–50.PubMedCrossRefGoogle Scholar
  7. 7.
    Angrisani L, Lorenzo M, Borrelli V, Giuffre M, Fonderico C, Capece G. Is bariatric surgery necessary after intragastric balloon treatment? Obes Surg. 2006;16:1135–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Busetto L, Enzi G, Inelmen EM, et al. Obstructive sleep apnea syndrome in morbid obesity: effects of intragastric balloon. Chest. 2005;128:618–23.PubMedCrossRefGoogle Scholar
  9. 9.
    Busetto L, Segato G, De Luca M, et al. Preoperative weight loss by intragastric balloon in super-obese patients treated with laparoscopic gastric banding: a case-control study. Obes Surg. 2004;14:671–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Carbonelli MG, Fusco MA, Cannistrà F, Andreoli A, De Lorenzo A. Body composition modification in obese patients treated with intragastric balloon. Acta Diabetol. 2003;40 Suppl 1:S261–2.PubMedCrossRefGoogle Scholar
  11. 11.
    de Goederen-van der Meij S, Pierik RG, Oudkerk Pool M, Gouma DJ, Mathus-Vliegen LM. Six months of balloon treatment does not predict the success of gastric banding. Obes Surg. 2007;17:88–94.PubMedCrossRefGoogle Scholar
  12. 12.
    Doldi SB, Micheletto G, Perrini MN, Rapetti R. Intragastric balloon: another option for treatment of obesity and morbid obesity. Hepato-gastroenterology. 2004;51:294–7.PubMedGoogle Scholar
  13. 13.
    Evans JD, Scott MH. Intragastric balloon in the treatment of patients with morbid obesity. Br J Surg. 2001;88:1245–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Francica G, Giardiello C, Iodice G, et al. Ultrasound as the imaging method of choice for monitoring the intragastric balloon in obese patients: normal findings, pitfalls and diagnosis of complications. Obes Surg. 2004;14:833–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Frutos MD, Morales MD, Lujan J, Hernandez Q, Valero G, Parrilla P. Intragastric balloon reduces liver volume in super-obese patients, facilitating subsequent laparoscopic gastric bypass. Obes Surg. 2007;17:150–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Galloro G, Sivero L, Magno L, et al. New technique for endoscopic removal of intragastric balloon placed for treatment of morbid obesity. Obes Surg. 2007;17:658–62.PubMedCrossRefGoogle Scholar
  17. 17.
    Ganesh R, Rao AD, Baladas HG, Leese T. The Bioenteric Intragastric Balloon (BIB) as a treatment for obesity: poor results in Asian patients. Singapore Med J. 2007;48:227–31.PubMedGoogle Scholar
  18. 18.
    Genco A, Bruni T, Doldi SB, et al. Bioenterics intragastric balloon: the Italian experience with 2,515 patients. Obes Surg. 2005;15:1161–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Genco A, Cipriano M, Bacci V, et al. BioEnterics Intragastric Balloon (BIB): a short-term, double-blind, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes. 2006;30:129–33.CrossRefGoogle Scholar
  20. 20.
    Herve J, Wahlen CH, Schaeken A, et al. What becomes of patients one year after the intragastric balloon has been removed? Obes Surg. 2005;15:864–70.PubMedCrossRefGoogle Scholar
  21. 21.
    Loffredo A, Cappuccio M, De Luca M, et al. Three years experience with the new intragastric balloon, and a preoperative test for success with restrictive surgery. Obes Surg. 2001;11:330–3.PubMedCrossRefGoogle Scholar
  22. 22.
    Martinez-Brocca MA, Belda O, Parejo J, et al. Intragastric balloon-induced satiety is not mediated by modification in fasting or postprandial plasma ghrelin levels in morbid obesity. Obes Surg. 2007;17:649–57.PubMedCrossRefGoogle Scholar
  23. 23.
    Mathus-Vliegen EM, Tytgat GN. Intragastric balloon for treatment-resistant obesity: safety, tolerance, and efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up. Gastrointest Endosc. 2005;61:19–27.PubMedCrossRefGoogle Scholar
  24. 24.
    Melissas J, Mouzas J, Filis D, et al. The intragastric balloon—smoothing the path to bariatric surgery. Obes Surg. 2006;16:897–902.PubMedCrossRefGoogle Scholar
  25. 25.
    Mion F, Napoleon B, Roman S, et al. Effects of intragastric balloon on gastric emptying and plasma ghrelin levels in non-morbid obese patients. Obes Surg. 2005;15:510–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Puglisi F, Antonucci N, Capuano P, et al. Intragastric balloon and binge eating. Obes Surg. 2007;17:504–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Roman S, Napoleon B, Mion F, et al. Intragastric balloon for “non-morbid” obesity: a retrospective evaluation of tolerance and efficacy. Obes Surg. 2004;14:539–44.PubMedCrossRefGoogle Scholar
  28. 28.
    Rossi A, Bersani G, Ricci G, Petrini C, Defabritiis G, Alvisi V. Intragastric balloon insertion increases the frequency of erosive esophagitis in obese patients. Obes Surg. 2007;17:1346–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Sallet JA, Marchesini JB, Paiva DS, et al. Brazilian multicenter study of the intragastric balloon. Obes Surg. 2004;14:991–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Spyropoulos C, Katsakoulis E, Mead N, Vagenas K, Kalfarentzos F. Intragastric balloon for high-risk super-obese patients: a prospective analysis of efficacy. Surg Obes Relat Dis. 2007;3:78–83.PubMedCrossRefGoogle Scholar
  31. 31.
    Totté E, Hendrickx L, Pauwels M, Van Hee R. Weight reduction by means of intragastric device: experience with The BioEnterics Intragastric Balloon. Obes Surg. 2001;11:519–23.PubMedCrossRefGoogle Scholar
  32. 32.
    Van Hee R, Van Wiemeersch S, Lasters B, Weyler J. Use of anti-emetics after intragastric balloon placement: experience with three different drug treatments. Obes Surg. 2003;13:932–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Wahlen CH, Bastens B, Herve J, et al. The BioEnterics Intragastric Balloon (BIB): how to use it. Obes Surg. 2001;11:524–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Weiner R, Gutberlet H, Bockhorn H. Preparation of extremely obese patients for laparoscopic gastric banding by gastric-balloon therapy. Obes Surg. 1999;9:261–4.PubMedCrossRefGoogle Scholar
  35. 35.
    National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. The evidence report. National Institutes of Health. 1998;6 Suppl 2:51S–209S.Google Scholar
  36. 36.
    Machytka E, Klvana P, Hanuskova L, Janik I. Use of pharmacotherapy for long-term maintenance of weight loss following explantation of intragastric balloon (BIB). Gut. 2007;57:A290.Google Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyGeneva University HospitalsGenevaSwitzerland

Personalised recommendations