Intra-Gastric Balloon (IGB)

The intra-gastric balloon is inserted using an endoscopy process (no surgery is required), with a general anaesthetic.

  • It allows patients to lose weight gradually, restoring the feeling of fullness (patients cease to feel hungry) by partially filling the stomach.
  • Insertion of the balloon is relatively non-aggressive, and the hospitalisation period is short (one or two days). Patients can resume their normal activities within a short period of time.
  • This method is totally reversible, since the balloon can be ablated endoscopically.
  • The balloon cannot remain in the body for more than six months, and so this is a temporary technique, unlike gastroplasty.

Indications

  • The intra-gastric balloon can be an alternative to surgery:
    • If the Body Mass Index is insufficient for gastroplasty (BMI between 30 and 35, or between 35 and 40, with no particular pathology aggravated by obesity).
    • If the BMI is sufficient to justify a gastroplasty, where the patient’s general health makes it inadvisable to perform transitory or major surgery.
  • The balloon option may be suggested for obese patients whose BMI is too high, making a gastroplasty operation extremely difficult. This allows patients to slim down enough to allow surgery to be carried out in suitable conditions.

Contraindications

  • Absolute contraindications: inter-gastric balloons will not be used
    • if the patient is a teenager,
    • if the patient has a sizeable hiatus hernia, or serious injuries.
  • Provisional contraindications:
    • active gastric or bulbous ulcers. These pathologies will be treated before the balloon is inserted.

Post-op monitoring

Clinical monitoring of patients following the insertion of an intra-gastric balloon is carried out on a weekly basis, and subsequently every month (biological monitoring in the event of vomiting, and radiological or echographic monitoring if fracture or migration is suspected).

Regular consultation with a dietician is essential additional therapy for long term mechanical treatment.

This method allows patients to lose weight in the short term. However, at a later stage, when the balloon has been ablated, either a gastroplasty or very strict nutrition monitoring should be proposed.

Background

  • Formerly the balloons used were quite heavy and weighed around 700 g, since they were filled with water. This created a number of problems and: poor tolerance, copious vomiting, fracture migrations, ulceration, haemorrhaging and gastric perforation.
  • Now the balloons are filled with air, and are much lighter at around 20 g. Their tolerance is better, and in general they pose much fewer problems.

Complications

Any medical action, investigation, exploration or operation on the human body, even when performed to the highest degree of competence and levels of safety in accordance with the data now provided by science and within current regulations, involves the risk of complications.

  • Complications in the intra-gastric balloon insertion process are rare, and are chiefly related to the anaesthetic.
  • The immediate complications envisaged after an intra-gastric balloon has been inserted are functional and involve bouts of vomiting, although this condition rarely requires the patient to be hospitalised again for a rehydratation process.
  • Gastric burns may occur while the balloon is in the patient’s body, and these may or may not be associated with inflammation of the oesophagus, or erosive gastritis. This condition disappears following medical treatment. Spasmodic abdominal pains with diarrhoea are removed by anti-spasmodic treatment. Premature removal of the device due to persistent vomiting or pain is still a rare phenomenon.
  • Other complications essentially relate to the old balloons used previously, since these were too weighty:
    • perforation of the gastric wall, whether or not after an attack of bulimia, can require an operation to be performed (with its own risks).
    • ulceration of the gastric wall.
    • haemorrhaging can require an operation in exceptional circumstances.
  • Other complications are possible, but are still exceptional cases, such as cardiovascular and respiratory disorders, infection and death. These complications may be improved by your medical or surgical history or by following certain treatments.