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Intragastric Balloon for Management of Severe Obesity: a Systematic Review

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Abstract

Older models of intragastric balloons (IGBs) had unacceptably high complication rates and inconsequential weight loss. With FDA approval of newer models, we aimed to systematically examine the literature regarding the efficacy of IGB therapy for obesity. A comprehensive electronic database search was completed. Title searching was restricted to the following keywords: bariatric, gastric, gastric bypass, gastric band, sleeve gastrectomy, and intragastric balloon. Twenty-six primary studies (n = 6101) were included. At balloon removal, mean change in weight and BMI were 15.7 ± 5.3 kg and 5.9 ± 1.0 kg/m2. The most common complications were nausea/vomiting (23.3 %) and abdominal pain (19.9 %). Serious complications were rare: mortality (0.05 %) and gastric perforation (0.1 %). IGBs are associated with marked short-term weight loss with limited serious complications.

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References

  1. Maggard MA, Shugarman LR, Suttorp M, Maglione M, Sugerman HJ, Livingston EH, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.

    Article  PubMed  Google Scholar 

  2. Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:CD003641.

    Google Scholar 

  3. Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.

    Article  CAS  PubMed  Google Scholar 

  4. Schwartz A, Etchechoury L, Collet D. Outcome after laparoscopic gastric bypass for super-super obese patients. J Visc Surg. 2013;150(2):145–9.

    Article  CAS  PubMed  Google Scholar 

  5. Villamere J, Gebhart A, Vu S, Nguyen NT. Body mass index is predictive of higher in-hospital mortality in patients undergoing laparoscopic gastric bypass but not laparoscopic sleeve gastrectomy or gastric banding. Am Surg. 2014;80(10):1039–43.

    PubMed  Google Scholar 

  6. Zerrweck C, Sepulveda EM, Maydon HG, Campos F, Spaventa AG, Pratti V, et al. Laparoscopic gastric bypass vs. sleeve gastrectomy in the super obese patient: early outcomes of an observational study. Obes Surg. 2014;24(5):712–7.

    Article  PubMed  Google Scholar 

  7. Wadden TA, Hollander P, Klein S, Niswender K, Woo V, Hale PM, et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE maintenance randomized study. Int J Obes. 2013;37(11):1443–51.

    Article  CAS  Google Scholar 

  8. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology. 2012;142(7):1592–609.

    Article  PubMed  Google Scholar 

  9. Faria SL, Faria OP, de Almeida Cardeal M, Ito MK. Effects of a very low calorie diet in the preoperative stage of bariatric surgery: a randomized trial. Surg Obes Relat Dis. 2015;11(1):230–7.

    Article  PubMed  Google Scholar 

  10. Nieben OG, Harboe H. Intragastric balloon as an artificial bezoar for treatment of obesity. Lancet. 1982;1(8265):198–9.

    Article  CAS  PubMed  Google Scholar 

  11. Phillips RJ, Powley TL. Gastric volume rather than nutrient content inhibits food intake. Am J Phys. 1996;271(3 Pt 2):R766–9.

    CAS  Google Scholar 

  12. Bell EA, Roe LS, Rolls BJ. Sensory-specific satiety is affected more by volume than by energy content of a liquid food. Physiol Behav. 2003;78(4–5):593–600.

    Article  CAS  PubMed  Google Scholar 

  13. Ello-Martin JA, Ledikwe JH, Rolls BJ. The influence of food portion size and energy density on energy intake: implications for weight management. Am J Clin Nutr. 2005;82(1 Suppl):236S–41S.

    CAS  PubMed  Google Scholar 

  14. Fuller NR, Pearson S, Lau NS, Wlodarczyk J, Halstead MB, Tee HP, et al. An intragastric balloon in the treatment of obese individuals with metabolic syndrome: a randomized controlled study. Obesity (Silver Spring). 2013;21(8):1561–70.

    Article  Google Scholar 

  15. Alfredo G, Roberta M, Massimiliano C, Michele L, Nicola B, Adriano R. Long-term multiple intragastric balloon treatment—a new strategy to treat morbid obese patients refusing surgery: prospective 6-year follow-up study. Surg Obes Relat Dis. 2014;10(2):307–11.

    Article  PubMed  Google Scholar 

  16. Al-Momen A, El-Mogy I. Intragastric balloon for obesity: a retrospective evaluation of tolerance and efficacy. Obes Surg. 2005;15(1):101–5.

    Article  PubMed  Google Scholar 

  17. Angrisani L, Lorenzo M, Borrelli V, Giuffre M, Fonderico C, Capece G. Is bariatric surgery necessary after intragastric balloon treatment? Obes Surg. 2006;16(9):1135–7.

    Article  PubMed  Google Scholar 

  18. Coskun H, Bostanci O, Dilege E, Bozbora A. BioEnterics intragastric balloon: clinical outcomes of the first 100 patients—a Turkish experience. Obes Surg. 2008;18(9):1154–6.

    Article  PubMed  Google Scholar 

  19. Dastis NS, Francois E, Deviere J, Hittelet A, Ilah Mehdi A, Barea M, et al. Intragastric balloon for weight loss: results in 100 individuals followed for at least 2.5 years. Endoscopy. 2009;41(7):575–80.

    Article  PubMed  Google Scholar 

  20. de Goederen-van d, 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(1):88–94.

    Article  Google Scholar 

  21. Genco A, Bruni T, Doldi SB, Forestieri P, Marino M, Busetto L, et al. BioEnterics intragastric balloon: the Italian experience with 2,515 patients. Obes Surg. 2005;15(8):1161–4.

    Article  CAS  PubMed  Google Scholar 

  22. Giuricin M, Nagliati C, Palmisano S, Simeth C, Urban F, Buri L, et al. Short- and long-term efficacy of intragastric air-filled balloon (heliosphere(R) BAG) among obese patients. Obes Surg. 2012;22(11):1686–9.

    Article  CAS  PubMed  Google Scholar 

  23. Gottig S, Daskalakis M, Weiner S, Weiner RA. Analysis of safety and efficacy of intragastric balloon in extremely obese patients. Obes Surg. 2009;19(6):677–83.

    Article  PubMed  Google Scholar 

  24. Herve J, Wahlen CH, Schaeken A, Dallemagne B, Dewandre JM, Markiewicz S, et al. What becomes of patients one year after the intragastric balloon has been removed? Obes Surg. 2005;15(6):864–70.

    Article  CAS  PubMed  Google Scholar 

  25. Koerner J, Wallstabe I, Tiedemann A, Schiefke I, Geigenmüller G, Haberzettl D, et al. Pp225-Mon safety and weight reduction with the endoscopic intragastric balloon system as part of a multimodality obesity treatment program. Clin Nutr. 2013;32:S206.

    Article  Google Scholar 

  26. Lecumberri E, Krekshi W, Matia P, Hermida C, de la Torre NG, Cabrerizo L, et al. Effectiveness and safety of air-filled balloon heliosphere BAG(R) in 82 consecutive obese patients. Obes Surg. 2011;21(10):1508–12.

    Article  PubMed  Google Scholar 

  27. Loffredo A, Cappuccio M, De Luca M, de Werra C, Galloro G, Naddeo M, et al. Three years experience with the new intragastric balloon, and a preoperative test for success with restrictive surgery. Obes Surg. 2001;11(3):330–3.

    Article  CAS  PubMed  Google Scholar 

  28. Lopez-Nava G, Rubio MA, Prados S, Pastor G, Cruz MR, Companioni E, et al. BioEnterics(R) intragastric balloon (BIB(R)). Single ambulatory center Spanish experience with 714 consecutive patients treated with one or two consecutive balloons. Obes Surg. 2011;21(1):5–9.

    Article  PubMed  Google Scholar 

  29. Mathus-Vliegen EM, Tytgat GN. Intragastric balloons for morbid obesity: results, patient tolerance and balloon life span. Br J Surg. 1990;77(1):76–9.

    Article  CAS  PubMed  Google Scholar 

  30. Mion F, Gincul R, Roman S, Beorchia S, Hedelius F, Claudel N, 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(6):764–9.

    Article  PubMed  Google Scholar 

  31. Peker Y, Durak E, Ozgurbuz U. Intragastric balloon treatment for obesity: prospective single-center study findings. Obes Facts. 2010;3(2):105–8.

    Article  PubMed  Google Scholar 

  32. Roman S, Napoleon B, Mion F, Bory RM, Guyot P, D'Orazio H, et al. Intragastric balloon for “non-morbid” obesity: a retrospective evaluation of tolerance and efficacy. Obes Surg. 2004;14(4):539–44.

    Article  PubMed  Google Scholar 

  33. Sallet JA, Marchesini JB, Paiva DS, Komoto K, Pizani CE, Ribeiro ML, et al. Brazilian multicenter study of the intragastric balloon. Obes Surg. 2004;14(7):991–8.

    Article  PubMed  Google Scholar 

  34. 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(1):78–83.

    Article  PubMed  Google Scholar 

  35. Stimac D, Majanovic SK, Turk T, Kezele B, Licul V, Orlic ZC. Intragastric balloon treatment for obesity: results of a large single center prospective study. Obes Surg. 2011;21(5):551–5.

    Article  PubMed  Google Scholar 

  36. Tai CM, Lin HY, Yen YC, Huang CK, Hsu WL, Huang YW, et al. Effectiveness of intragastric balloon treatment for obese patients: one-year follow-up after balloon removal. Obes Surg. 2013;23(12):2068–74.

    Article  PubMed  Google Scholar 

  37. Totte 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(4):519–23.

    Article  CAS  PubMed  Google Scholar 

  38. Crea N, Pata G, Della Casa D, Minelli L, Maifredi G, Di Betta E, et al. Improvement of metabolic syndrome following intragastric balloon: 1 year follow-up analysis. Obes Surg. 2009;19(8):1084–8.

    Article  PubMed  Google Scholar 

  39. Gaggiotti G, Tack J, Garrido Jr 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(7):949–56.

    Article  PubMed  Google Scholar 

  40. Riess KP, Baker MT, Lambert PJ, Mathiason MA, Kothari SN. Effect of preoperative weight loss on laparoscopic gastric bypass outcomes. Surg Obes Relat Dis. 2008;4(6):704–8.

    Article  PubMed  Google Scholar 

  41. Tarnoff M, Kaplan LM, Shikora S. An evidenced-based assessment of preoperative weight loss in bariatric surgery. Obes Surg. 2008;18(9):1059–61.

    Article  PubMed  Google Scholar 

  42. Liu RC, Sabnis AA, Forsyth C, Chand B. The effects of acute preoperative weight loss on laparoscopic roux-en-Y gastric bypass. Obes Surg. 2005;15(10):1396–402.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Alberta, Edmonton, Alberta, Canada

    Ekua Yorke, Noah Jacob Switzer, Christopher de Gara, Daniel Birch & Shahzeer Karmali

  2. 2D, Walter C Mackenzie Health Sciences Centre, University of Alberta, 840-112 Street, Edmonton, Alberta, T6G 2B7, Canada

    Noah Jacob Switzer

  3. Department of Surgery, University of Calgary, Calgary, Alberta, Canada

    Artan Reso, Richdeep Gill & Shahzeer Karmali

  4. Center for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandria Hospital, Edmonton, Alberta, Canada

    Xinhe Shi, Christopher de Gara & Daniel Birch

Authors
  1. Ekua Yorke
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Correspondence to Noah Jacob Switzer.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Conflict of Interest

Ekua Yorke, Noah J. Switzer, Artan Reso, Xinhe Shi, Christopher de Gara, and Richdeep Gill declare that they have no conflict of interest.

Daniel Birch- consultant for Johnson & Johnson Ethicon Endosurgery and Covidien. He also has received educational grants from Covidien, Johnson & Johnson Ethicon Endosurgery and Stryker, and teaching honoraria from Cook Surgery and Bard Davol.

Shahzeer Karmali—consultant for Gore and Ethicon

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Yorke, E., Switzer, N.J., Reso, A. et al. Intragastric Balloon for Management of Severe Obesity: a Systematic Review. OBES SURG 26, 2248–2254 (2016). https://doi.org/10.1007/s11695-016-2307-9

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  • DOI: https://doi.org/10.1007/s11695-016-2307-9

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