Original articleIntragastric balloon outcomes in super-obesity: a 16-year city center hospital series
Section snippets
Intragastric balloon technique and follow-up
After the bariatric multidisciplinary decision to perform IGB therapy, informed consent was obtained from patients. General anesthesia was administered, and complete diagnostic gastroduodenoscopy was performed assessing the esophagus, stomach, and duodenum. If no contraindications to balloon insertion were present (e.g., macroscopically visible gastrointestinal pathology or large hiatus hernia), the endoscope was removed and, with anesthetic guidance, a prerolled silicone balloon (ORBERA;
Patient characteristics
Two hundred seven patients were included in the study, of whom 76 (31%) underwent IGB placement only, 51 (21%) had IGB followed by gastric band, 53 (22%) had IGB followed by gastric bypass surgery, and 27 (11%) had IGB followed by gastric sleeve surgery. The choice of intervention was based on a discussion in a dedicated bariatric MDT as well as patient preference. Although the aim of the insertion of gastric balloons was to ultimately prepare patients for definitive bariatric surgery, in
Discussion
Our results demonstrate the long-term weight loss efficacy of IGB when used as an initial weight loss trigger in the context of an established bariatric pathway with definitive bariatric procedures (such as Roux-en-Y gastric bypass and sleeve gastrectomy). While the application of IGBs before definite bariatric surgery is an accepted practice in some centers [32], [33], [34], our results further support this approach, with additional evidence demonstrating the durability of IGBs in SO as a
Conclusion
In this paper, we report our long-term, single-institute experience in using the IGB alone and as a precursor to definite bariatric surgery for SO patients at a large city specialist bariatric center. We show a small effect in weight loss when using IGB and lifestyle changes alone, and these effects appear to be short term. However, a large and sustained weight loss effect is shown when IGBs are combined with definite bariatric surgery, in particular stapled procedures. We suggest that IGBs
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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