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INTRAGASTRIC BALLOON
INTRAGASTRIC BALLOON
for treatment of obesity and overweight

The intragastric balloon is a medical device which has been tested on an international scale. It helps patients take control of their weight without any of the risks associated with bariatric surgery or anorectic drugs. In fact the intragastric balloon induces a feeling of satiety thus reducing the urge to eat and, when combined with a balanced, low-calorie diet, an integrated physical activity program and behavioural therapy, it allows the patient to modify the shape of his/her body in a safe and efficacious manner, improving overall health and quality of life.

Indications

The intragastric balloon is designed to facilitate weight loss in obese people (BMI > 30 Kg/m≤ with comorbidity, or BMI > 35, even without comorbidity) who have not managed to achieve long-term weight loss on other weight control programs (BIB system).
The intragastric balloon is particularly useful in the treatment of morbidly obese patients, be they candidates for bariatric surgery or not: in fact use of the BIB system to reduce a patient's weight prior to surgery helps to limit those risks associated with the subsequent operation. As of February 2010, use of the intragastric balloon has also been extended to treat overweight people (BMI of 27 kg/m≤ or over) who fail to lose weight on controlled dietary regimes (Orbera system).

Contraindications

- Severe active esophagitis - Large hiatal hernia (> 5 cm)
- Active gastric and/or duodenal ulcer
- Previous resective surgery of the gastroenteric tract - Crohn's disease - Neoplasms
- Active oesophageal-gastro-duodenal bleeding or oesophageal
- gastric lesions which may bleed - Patients being treated with gastrolesive drugs or anticoagulants
- Patients suffering from psychiatric disorders or uncooperative
- Alcohol or drug addiction

Insertion and removal

The BIB/Orbera intragastric balloon (manufactured by Allergan) consists of a soft, expandable balloon connected to a positioning tube which allows the endoscopist to insert the balloon inside the patient’s stomach via the mouth and oesophagus Prior to insertion, the doctor performs an oesophageal-gastro-duodenal endoscopy and if no contraindications are found the balloon is then passed through the mouth and oesophagus to be positioned in the stomach.† The balloon is positioned in the stomach while still deflated. Once it has been positioned the balloon is filled with sterile saline solution and methylene blue. The balloon is fitted with a self-sealing valve and once the filling tube has been removed, it floats freely in the stomach. The device can be placed in the patient’s stomach in just 20 - 30 minutes. The balloon partially fills the patient’s stomachs to create a sense of fullness. The intragastric balloon is left in the stomach for a maximum of six months.† The balloon is removed through the patients oesophagus and mouth using endoscopy to guide the operation: The balloon is first pierced and deflated before it is then picked up and permanently removed using special extractor tweezers.
Insertion and removal operations are carried out in an outpatients room under heavy sedation with anaesthesiological assistance. At the end of the procedure the patient is kept under observation for a short period of time before being allowed to return home.

Risks

As with all medical-surgical procedures there is always a risk of unforeseen and unknown reactions and complications. These vary from one individual to another. The possible complications which may arise are: dehydration and electrolyte imbalance, gastric lesions (ulceration, bleeding, perforation) or† anaesthesiological problems (respiratory depression). Surgery may be needed to remedy some of these complications. Blue urine or blue vomit experienced by the patient are a sign that the balloon has burst.

Side effects

During the first few days following balloon insertion the patient may suffer from nausea or vomiting which is easily controlled using drugs.† There remains a possibility of poor weight loss, usually due to the patient not adhering to the set diet plan. On the other hand, there is also the possibility of encountering excessive or uncontrolled weight loss which could have an adverse effect on the patient's health. Consequently periodical clinical monitoring of the patient is necessary throughout treatment.

Call centre for information and bookings

Segreteria U.O.S. di Endoscopia e Gastroenterologia (Secretary for the Endoscopy and Gastroenterology Simple Organizational Unit)

Tel: + 378 0549 99454, Wednesday afternoon from 5 - 6 pm (Dr. CalÚ) and Thursday afternoon from 2 - 3 pm. (Dr. Piscaglia)
E-mail: endoscopia.segreteria@iss.sm

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