Definition & Overview
Gastric balloon is a weight loss procedure that involves the placement of saline-filled balloon into the stomach to suppress appetite and drastically reduce food intake. Also referred to as endoscopic intragastric balloon, this is one of the methods currently in use to tackle obesity.
The rising incidence of obesity in most countries in the world has led to the development of several treatment methods. Though there are some short-term weight loss plans, most obese patients still prefer procedures that provide long-term results in reducing and controlling their weight. This goal is not just for aesthetic purposes but also to minimise the risk of developing diseases and serious medical conditions associated with too much fat tissue in the body.
Gastric balloon is loosely considered as part of bariatric or weight loss surgery. It is typically indicated for people with body mass index of 27 or more. If combined with exercise and proper diet, it can translate to significant weight loss.
There are several types of silicone balloons used for this procedure, including single silicone balloon, two connected silicone balloon, and single adjustable silicone balloon. Apart from the saline solution, most of these balloons also contain methylene blue dye that turns urine green.
Who Should Undergo and Expected Results
Patients diagnosed with obesity are given the option to undergo gastric balloon procedure, especially if they have associated health risks such as diabetes and hypertension. It can also be considered by those who had tried other weight control programmes but are unable to achieve the desired results. To qualify, the patient must have a body mass index of at least 27 and would need to lose a minimum of 10 kg of weight before the procedure. It is also indicated for patients who qualify for more radical surgical weight loss procedures, such as the removal of a part of the stomach, but wish to try a less aggressive method.
This procedure has high satisfaction rate among patients, with most of them achieving an average of 30% weight loss. With a consistent diet and exercise plan, the results of this procedure could become permanent. After a maximum of six months, the patient needs to have the balloon deflated and removed from the stomach.
How is the Procedure Performed?
The procedure starts with numbing the throat with anaesthetic spray to prepare for the insertion of instruments. A plastic guard is used to keep the mouth open during the procedure. A small tube called the endoscope is then inserted and advanced until it reaches the stomach. A small camera is located at its tip to provide imaging allowing the physician to check impediments or abnormalities in the pathway and the stomach itself. The endoscope is then removed and a deflated balloon is passed through and positioned in the stomach. The balloon is then inflated with saline solution and methylene blue dye. A sealing valve is placed once the balloon is filled. If necessary, the physician will insert the endoscope again to ensure proper balloon placement. The procedure ends with the removal of the endoscope.
The procedure is usually performed on an outpatient basis and takes half an hour to complete. Patients are required to rest for several days, to avoid any strenuous physical activities, and to follow a restricted diet for three days after gastric balloon placement.
After a few months, the balloon will be removed through a similar procedure. It is first deflated and taken out using specialised tweezers.
Possible Risks and Complications
The patient may experience vomiting and nausea immediately following the placement of gastric balloon. This often happens as the stomach adjusts to the presence of the silicone balloon.
Meanwhile, the insertion of the endoscope and other specialised instruments could lead to gastric lesions, which could cause bleeding and perforation of gastric walls. The procedure could also injure the walls of the oesophagus.
The presence of a foreign object inside the stomach could have physiological consequences, such as dehydration and imbalance of electrolytes in the body.
Some patients also suffer from a stomach ulcer, which can be avoided by taking medications for as long as the balloon is in the stomach.
There is also the possibility of simultaneous deflation of the gastric balloon. If not removed, the deflated balloon could cause stomach blockage.
Leslie D, Kellogg TA, Ikramuddin S. Bariatric surgery primer for the internist: keys to the surgical consultation. Med Clin North Am. 2007;91:353-81. PMID: 17509383 www.ncbi.nlm.nih.gov/pubmed/17509383.
Richards WO. Morbid obesity. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 15.