Laparoscopic Gastric Balloon
|The gastric balloon is a good option if you are unsure about the gastric band surgery. It is medically proven that a good result with the balloon indicates a good result with the gastric band. If, on the other hand, the balloon does not work, then the band may be similarly ineffective, and the gastric bypass procedure is recommended instead.
The gastric balloon is placed in the stomach to create an early feeling of fullness during a small meal, causing a marked reduction in energy intake and weight reduction (figure 1). The best candidates are obese patients who do not fulfil the criteria for bariatric surgery, or super-obese patients who must lose weight prior to bariatric surgery, in order to prevent complications after the operation.
How it’s done
The balloon is guided endoscopically by a surgeon or an endoscopist, a procedure much like a classic endoscopic examination of the stomach (gastroscopy); it is performed without anaesthetic. The process lasts approximately 20 minutes. If the patient is anxious, he or she can be sedated with an intravenous drip prior to the endoscopic procedure.
The balloon is filled, via an external catheter, with air or a saline solution, depending on the type of balloon used. When filled, the balloon expands and floats freely within the stomach; it remains in place for at least 6 months before removal, again by endoscopy.
In two recent studies, each conducted at several centres, the mean percentage of excess weight loss was found to be 36 percent*. The weight loss was accompanied by improvements in obesity-related conditions, such as type-2 diabetes and hypertension.
Because the balloon must be removed after 6 months, long-term maintenance of weight loss is limited. For good long-term results, it is necessary to combine the balloon system with a system of behaviour for weight loss. The balloon’s value is to chiefly therapeutic, to induce behavioural changes after the procedure that can be maintained over a long period of time.
In the case of super-obese patients, bariatric surgery is recommended after the removal of the balloon.
We provide a detailed booklet containing the relevant dietary information and instructions; moreover, we take care to support each patient personally during the balloon period.
The majority of patients experience symptoms immediately after the installation of the balloon; these include nausea, vomiting, acid reflux or epigastric pain, and cramps. However, the stomach accommodates itself to the balloon within the first week, and these early symptoms then disappear. Occasionally the symptoms persist, and a premature deflation and removal of the balloon is required. This ‘balloon intolerance’ occurs approximately 5% of the time.
Other complications are rare, and include gastric and oesophageal injury during installation or removal of the balloon, gastric ulcers, and gastric outlet obstruction.