Abstract
Introduction
The use of intragastric balloons (IGB) for the treatment of obesity has been increasing significantly, with data confirming its effectiveness with low complication rates. Adjustable balloons are not widely available for use in all countries, including the USA. In this video, we demonstrate a unique technique in which a conventional nonadjustable balloon is modified to an adjustable balloon to improve weight loss.
Methods
A 35-year-old woman with a BMI of 36.1 kg/m2 (84.4 kg) who had failed prior medical therapy for obesity presented for IGB placement. After discussion with the patient, including risks and benefits, a conventional IGB modified to a novel adjustable IGB was placed.
Results
In this primary experience, we describe the use of a conventional IGB modified to an adjustable balloon. First, during balloon placement, an initial 500 ml of saline was instilled. At one-month follow-up, the patient only experienced 3.67%TBWL; thus, the balloon was adjusted with the addition of 160 ml of saline through the newly created modification catheter. At a 2-month follow-up, a second adjustment was performed with the addition of 180 ml, for a total of 840 ml. At 4 months, patient experienced 10% TBWL and decreased in BMI by 3.6 kg/m2. No adverse events were reported.
Conclusion
The transformation of a nonadjustable balloon into an adjustable balloon is feasible and effective in weight loss. This technique may be an alternative in cases where adjustable balloon is not available. Further studies are warranted to confirm the safety and efficacy of this novel device.
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References
Moura D, Oliveira J, De Moura EG, et al. Effectiveness of intragastric balloon for obesity: a systematic review and meta-analysis based on randomized control trials. Surg Obes Relat Dis. 2016;12(2):420–9.
Genco A, Dellepiane D, Baglio G, et al. Adjustable intragastric balloon vs non-adjustable intragastric balloon: case-control study on complications, tolerance, and efficacy. Obes Surg. 2013;23(7):953–8.
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Conflict of Interest
Leonardo Salles de Almeida has a patent for the adjustable implant kit.
Thiago Ferreira de Souza is a consultant for Apollo Endosurgery.
All other authors have no conflict of interest.
Ethical Approval
Institutional Review Board of the Hospital approved the study. Informed consent was obtained from the participant included in the study.
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de Almeida, L.S., Bazarbashi, A.N., de Souza, T.F. et al. Modifying an Intragastric Balloon for the Treatment of Obesity: a Unique Approach. OBES SURG 29, 1445–1446 (2019). https://doi.org/10.1007/s11695-019-03771-1
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DOI: https://doi.org/10.1007/s11695-019-03771-1