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Obesity Surgery

, Volume 19, Issue 6, pp 677–683 | Cite as

Analysis of Safety and Efficacy of Intragastric Balloon in Extremely Obese Patients

  • Stephan Göttig
  • Markos Daskalakis
  • Sylvia Weiner
  • Rudolf A. WeinerEmail author
Research Article

Abstract

Background

The implantation of an intragastric balloon constitutes a short-term effective non-surgical intervention to lose weight. The aim of this study was to evaluate retrospectively the clinical outcome and safety of gastric balloon therapy (GBT) in extremely obese patients.

Methods

One hundred and nine super- and super-super-obese patients, 64 males and 45 females, mean age 39.1 ± 8.4 years, mean body mass index (BMI) 68.8 ± 8.9 kg/m2, who underwent GBT for weight loss, were studied retrospectively. GBT was assessed in massively obese patients concerning tolerance, weight loss, number of comorbidities and complications.

Results

A significant reduction in patients’ weight and BMI was evident after GBT. Regarding safety, no major complications occurred. Minor complications at balloon placement and removal occurred in one (0.9%) and three patients (2.8%) respectively. Mean duration of GBT was 177.6 ± 56.8 days. After GBT, the mean weight loss was 26.3 ± 15.2 kg (p < 0.001) and the mean BMI reduction was 8.7 ± 5.1 kg/m2 (p < 0.001) representing a mean percentage of excess BMI lost (%EBL) of 19.7 ± 10.2. The highest BMI loss was observed in patients with BMI > 80 kg/m2. A noteworthy improvement of comorbidities in 56.8% of the patients was also noted. Of the 109 patients, 69 received subsequent bariatric surgery. All the procedures were performed laparoscopically. Ten patients, with a mean BMI of 68.6 ± 10.6 kg/m2 after the removal of the first BIB, received a second BIB resulting in a non-significant weight and BMI loss of 6.3 ± 9.4 kg and 1.8 ± 2.9 kg/m2, respectively.

Conclusions

Our study indicates the safety and efficacy of GBT in extremely obese patients particularly as a first step before a definitive anti-obesity operation. GBT appears to be a safe, tolerable, and potentially effective procedure for the initial treatment of morbid obesity.

Keywords

Intragastric balloon BIB Super-obesity Super-super-obesity Bariatric surgery Weight loss 

Notes

Conflict of interest

The authors disclose no commercial interest in the subject of study.

References

  1. 1.
    World Health Organization fact sheet No 311, September 2006. www.who.int/topics/obesity.
  2. 2.
    Deitel M. How much weight loss is sufficient to overcome major co-morbidities? Obes Surg. 2001;11:659.CrossRefGoogle Scholar
  3. 3.
    Levy P, Fried M, Santini F, et al. The comparative effects of bariatric surgery on weight and type 2 diabetes. Obes Surg. 2007;17:1248–56.CrossRefGoogle Scholar
  4. 4.
    Melissas J. IFSO Guidelines for Safety, Quality, and Excellence in Bariatric Surgery. Obes Surg. 2008;18:497–500.CrossRefGoogle Scholar
  5. 5.
    Imaz I, Martínez-Cervell C, García-Alvarez CE, et al. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg. 2008;18:841–6.CrossRefGoogle Scholar
  6. 6.
    Schapiro M, Benjamin S, Blackburn G, et al. Obesity and the gastric balloon: a comprehensive workshop. Gastrointest Endosc. 1987;33:323–7.CrossRefGoogle Scholar
  7. 7.
    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.CrossRefGoogle Scholar
  8. 8.
    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.CrossRefGoogle Scholar
  9. 9.
    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.CrossRefGoogle Scholar
  10. 10.
    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.CrossRefGoogle Scholar
  11. 11.
    Melissas J, Mouzas J, Filis D, et al. The intragastric balloon—smoothing the path to bariatric surgery. Obes Surg. 2006;16:897–902.CrossRefGoogle Scholar
  12. 12.
    Weiner S, Sauerland S, Fein M, et al. The Bariatric Quality of Life index: a measure of well-being in obesity surgery patients. Obes Surg. 2005;15:538–45.CrossRefGoogle Scholar
  13. 13.
    Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17:565–68.CrossRefGoogle Scholar
  14. 14.
    Pasulka PS, Bistrian BR, Benotti PN, et al. The risks of surgery in obese patients. Ann Intern Med. 1986;104:540–6.CrossRefGoogle Scholar
  15. 15.
    Alvarado R, Alami RS, Hsu G, et al. The impact of preoperative weight loss in patients undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15:1282–6.CrossRefGoogle Scholar
  16. 16.
    Liu RC, Sabnis AA, Forsyth C, et al. The effects of acute preoperative weight loss on laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15:1396–402.CrossRefGoogle Scholar
  17. 17.
    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.CrossRefGoogle Scholar
  18. 18.
    Frutos MD, Morales MD, Luján J, et al. Intragastric balloon reduces liver volume in super-obese patients, facilitating subsequent laparoscopic gastric bypass. Obes Surg. 2007;17:150–4.CrossRefGoogle Scholar
  19. 19.
    Fernandes M, Atallah AN, Soares BG, et al. Intragastric balloon for obesity. Cochrane Database Syst Rev. 2007; 1: CD004931.Google Scholar
  20. 20.
    Rossi A, Bersani G, Ricci G, et al. Intragastric balloon insertion increases the frequency of erosive esophagitis in obese patients. Obes Surg. 2007;17:1346–9.CrossRefGoogle Scholar
  21. 21.
    Totté E, Hendrickx L, Pauwels M, et al. Weight reduction by means of intragastric device: experience with the bioenterics intragastric balloon. Obes Surg. 2001;11:519–23.CrossRefGoogle Scholar
  22. 22.
    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
  23. 23.
    Sallet JA, Marchesini JB, Paiva DS, et al. Brazilian multicenter study of the intragastric balloon. Obes Surg. 2004;14:991–8.CrossRefGoogle Scholar
  24. 24.
    Spyropoulos C, Katsakoulis E, Mead N, et al. Intragastric balloon for high-risk super-obese patients: a prospective analysis of efficacy. Surg Obes Relat Dis. 2007;3:78–83.CrossRefGoogle Scholar
  25. 25.
    Angrisani L, Lorenzo M, Borelli V, et al. Is bariatric surgery necessary after intragastric balloon treatment? Obes Surg. 2006;16:1135–7.CrossRefGoogle Scholar
  26. 26.
    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.CrossRefGoogle Scholar
  27. 27.
    Doldi SB, Micheletto G, Perrini MN, et al. Treatment of morbid obesity with intragastric balloon in association with diet. Obes Surg. 2002;12:583–7.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Stephan Göttig
    • 1
  • Markos Daskalakis
    • 1
  • Sylvia Weiner
    • 1
  • Rudolf A. Weiner
    • 1
    • 2
    Email author
  1. 1.Department of General and Bariatric SurgeryCenter for Minimal-Invasive Surgery, Krankenhaus SachsenhausenFrankfurt am MainGermany
  2. 2.Department of SurgeryKrankenhaus SachsenhausenFrankfurt am MainGermany

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