Intragastric Balloon for the Management of Super-Obese Patients
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- Category: Vol. 78, March 2010
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Intragastric Balloon for the Management of Super-Obese Patients, ALAA A. SAFTY and ZAFER S. MATER
Abstract
Background: Obesity is one of the major public health problem of modern society. Super-obese patients with many co-morbidities present a challenge in bariatric surgery because of the high perioperative morbidity and mortality. Previous attempts to manage obesity with the use of intra-gastric balloon prostheses in the 1980's achieved very disappointing results. The BioEnterics intragastric balloon (BIB) is an endoscopic device used preoperatively to induce weight loss to reduce the risk of surgery for morbid obesity. The present prospective study was done to assess the safety and effect of the use of Bioenterics® balloon model (Inamed) for obesity treatment.
Methods: From November 2004 to April 2006, the BIB was endoscopically placed in 3 8 high-risk super-obese patients with a mean body mass index of 55.3±9.8kg/m2 and severe co-morbidities (mean 4.33±1.12, range 3-7). Exclusion criteria included psychiatric disease, large hiatal hernia and peptic ulcer disease. The BIB was endoscopically removed 6 months later, at which time the patients were evaluated in terms of weight loss and improvement of co-morbid conditions.
Results: BIB placement was uneventful in all patients. The major side effect related to the procedure was occasional vomiting during the first 2 days (65%). The mean weight loss was 58.3±18.4 kg and clinical re-evaluation revealed significant improvement in patient co-morbidity status (mean 2.23±.7, range 1-3; p=.024). Thirty patients underwent a primary bariatric surgical procedure few days after BIB removal; 8 patients were rejected for surgery because of inadequate weight loss.
Conclusions: Intra-gastric balloon placement is a safe and effective first-stage treatment of high-risk super-obese patients in need of surgical intervention. Although not without risk, it is generally a simple procedure leading to satisfactory weight loss, improvement in co-morbidities and consequent reduction of the perioperative mortality and morbidity rates associated with surgery.