Gastric Balloon Procedure

Overview

The Gastric Balloon is a soft silicone balloon that is inserted into the stomach using a routine gastroscopy procedure and inflated with saline through a self-sealing valve. By partially filling the stomach, the Gastric Balloon induces feelings of satiety, thus reducing food intake and aiding weight loss. It is indicated for temporary use in weight-loss therapy for overweight and obese patients with a body mass index (BMI) >= 27 kg/m².

The health risks of being overweight, in terms of cardiovascular disease, Diabetes Type 2, musculoskeletal disorders and some cancers are well known. Recent evidence from a large prospective, 10 year follow-up of over 500,000 middle aged men and women showed a 2-3 fold greater risk of mortality in obese (BMI > 30) than non obese individuals, and a 20-40% increased risk of death in overweight (BMI > 25) subjects - confirming the dangers of excess body weight at all levels¹.

National and international obesity guidelines demonstrate the importance of a range of effective pharmacological, psychological, endoscopic and surgical treatments, tailored to the needs of individual patients^2-5.

The Gastric Balloon, used in conjunction with a long-term supervised diet and lifestyle modification programme, is designed to increase the possibility of sustaining long-term weight loss. The balloon is designed for maximum placement duration of six months.

Intragastric balloons have been used in the management of obesity for over 20 years. Early devices proved unsatisfactory due to their design, construction and integrity. The BIB system (now known as the Orbera System), which was originally introduced in 1997, addressed many of the concerns of previous devices. The device has undergone significant refinements and improvements to the acid resistant shell and valve design which were completed in 2004. Accumulating clinical experience indicates that this superior device is effective, reliable and well tolerated by patients^6-8. As a result, there is growing interest in the use of the Gastric Balloon from physicians involved in the management of overweight and obese patients.

International intragastric balloon experts with experience in over 6000 patients collaborated on an Expert Consensus paper⁹, which forms the basis for the material to follow. The goal was to identify a global standard of care for managing the Gastric Balloon patient. Key issues addressed are: selecting, preparing and monitoring patients, inserting and retrieving the balloon and optimising outcomes.

Introduction

The Gastric Balloon system was introduced in 1997 and over 80,000 units have been implanted to date. Improvements to the balloon’s outer shell and valve were introduced in 2004 and the system has been shown to be safe and effective.

As part of a supervised diet and lifestyle modification programme the Gastric Balloon is a useful tool in helping patients with a BMI  27+ and previous poor record of dietary success to achieve significant weight loss over the six months that the device is in place.

The device may also help patients modify their eating behaviour to sustain weight loss post-removal.

To achieve the best outcomes, patients should be carefully selected, fully informed of the benefits and potential side effects of the procedure, well motivated and possessing realistic expectations for success.