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Endoscopic Intragastric Balloon

The endoscopic intragastric balloon treatment is a non-surgical method to help lose weight in patients who suffer from obesity or morbid obesity. It is an endoscopic procedure, during which a balloon is inserted in the stomach, occupying about half of it. The balloon remains in the stomach for a maximum of six months and it is meant to increase the feeling of satiety and limit food intake. Since it does not require surgery, the procedure is conducted in an out-patient setting.

What Endoscopic Intragastric Balloon Treatment Involves

The gastric ballon is a soft, biocompatible silicone device that is filled with sterile saline solution that is placed during a non-surgical procedure that takes between 20 and 30 minutes. The physician will insert the unfilled gastric balloon through the mouth and oesophagus into the stomach, using an endoscopic camera. Following the procedure, which can be conducted under local or general anesthesia according to the characteristics of the patient, the physician uses a fluid supply tube to fill the gastric ballon.

The endoscopic intragastric ballon does not cause weight loss directly — it increases the feeling of satiety, which means that it requires a patient’s commitment to weight loss. Therefore, the treatment is indicated for patients with a Body Mass Index (BMI) from 30 to 70 that are not eligible for weight loss surgery or who want a temporary weight loss option. Being motivated to lose weight, which can be done with the help of medically supervised weight loss programs, and accepting both the implant and the after care are determinant. It is, however, not recommended in cases of binge eating, stress eating or for patients who suffer from heartburn or diabetes.

Following the Endoscopic Intragastric Balloon Placement

After the introduction of the endoscopic intragastric balloon, the physician will monitor the patient’s reaction to it before discharge from the hospital. During the first week with the balloon, the patient will initiate a liquid diet, after which solid food can be eaten, respecting a healthy diet recommended by the medical team. The patient can lose 15 to 25 kg with the balloon, but it will depend on the behavioral changes conducted along with the implementation of the device.

During the treatment, the physician will monitor weight loss to ensure the success of the procedure as well as determine the removal of the balloon, after no more than six months. To remove the balloon, the physician will again introduce an endoscopic camera through the esophagus into the stomach in order to puncture the balloon. It is then deflated and removed with the help of forceps.

Single balloon endoscopy

For single balloon endoscopy, a 200 cm long flexible, fiberoptic, endoscope (a hose-like tube one centimeter in diameter with a light and a camera on the tip) is fitted with an equally long overtube that slides the full length of the endoscope. On the tip of the overtube is a balloon that can be inflated and deflated. The balloon is blown up to anchor the overtube within the intestine. While the overtube is anchored, the endoscope can be advanced further into the small intestine. By withdrawing the overtube the small intestine can be shortened and straightened to make the passage of the inner endoscope easier. The balloon may then be deflated so that the overtube can be inserted further and the endoscope advanced again. The endoscope itself is a standard endoscope with working channels that allow the intestine to be inflated with air, rinsed with water, or used to guide biopsy or electrocautery instruments to the tip of the endoscope.

Double balloon endoscopy

For double balloon endoscopy, similar equipment is used, but a second balloon is located on the tip of the endoscope. Both balloons – the one on the overtube and the one on the endoscope – can be alternatively inflated to anchor the overtube or the endoscope to assist with the passage of the endoscope or overtube, respectively.