Installation of an intragastric balloon

Suprun Alexey * Bariatric Surgeon * Suprun Alexey * Bariatric Surgeon

Suprun Alexey * Bariatric Surgeon

Today, the intragastric balloon is the primary bariatric procedure that is performed without surgery.

The essence of the procedure is the installation of a silicone balloon filled with saline solution and stained with methylene blue.

The filling volume of the cylinder varies between 500 and 800 ml.

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    Bariatric surgeri - Suprun Alexey
    Bariatric surgeri - Suprun Alexey

    About the doctor

    Suprun Alexey

    D. thesis in 2012 on “Clinical and pathogenetic features of diagnosis and treatment of pulmonary contusion in severe combined trauma”.

    Author of 36 printed works and 1 methodical recommendation. 5 articles were published in the journals recommended by VAK.

    Surgery

    About the procedure for inserting
    intragastric balloons

    Intragastric balloon placement is an exceptionally reactive (i.e., restrictive) bariatric procedure.

    The mechanism of its action is that an internally filled gastric balloon reduces the free volume of the stomach, so that the patient can not eat a large amount of food at one time.

    The intragastric balloon is inserted for a maximum of six months. After this period, the balloon must be removed. It is not recommended to leave it in place for a longer period of time because of the possibility of complications such as infection, intestinal obstruction, gastric ulcer and others.

    Installation of an intragastric balloon

    Cylinder installation procedure

    Patients come to our clinic on an empty stomach. Intragastric balloon placement is performed either under sedation (medical sleep) or under general anesthesia – the method of placement is determined individually. The procedure also requires a minimal examination in the clinic. Thus, balloon placement is performed according to the results of clinical and biochemical blood tests, ECG and lung X-ray.

    The procedure itself begins with a diagnostic gastroscopy. A balloon guide is then inserted into the stomach under the control of the gastroscope.

    Using the delivery system, the balloon is filled with the required volume of saline solution, after which the guide is disconnected and the balloon remains in the stomach. At the end of this step, the procedure is considered complete.

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      First days after the procedure

      During the first few days after insertion, the body perceives the balloon as a large foreign body and, of course, tries its best to get rid of it. This is associated with the appearance of uncomfortable symptoms, in particular nausea and vomiting.

      This is why we hospitalize patients for 24 hours after the procedure to give them venous infusion therapy and large doses of centrally acting antiemetics (ondosetron). Such support allows to survive the first two days after the intervention more comfortably. Some patients refuse hospitalization and are discharged immediately after balloon placement, which is also quite acceptable.

      Risks

      Complications after the procedure

      Complications are most often associated with rupture of the balloon walls and, as a consequence, its further migration from the stomach under the action of peristalsis.

      It should be noted that the liquid with which the cylinder is filled is specially colored with blue. If the integrity of the balloon walls is breached, the blue will stain the urine with a characteristic color. This will signal to the patient that the balloon should be removed immediately.

      If this situation does occur, it is critical to remove the balloon while it is still in the stomach. Otherwise, surgery will have to be performed to cut into the intestine and retrieve it surgically. Failure to do so may result in acute intestinal obstruction.

      Installation of an intragastric balloon

      Results after balloon installation

      The intragastric balloon can be considered both as a stand-alone bariatric procedure for weight loss and as a procedure to prepare for another bariatric surgery, i.e. for preoperative weight loss. For example, it is quite often recommended for obese patients in order to reduce risks during surgery and improve the postoperative outcome.

      However, do not overestimate the procedure of intragastric balloon installation and expect a large weight loss, especially for patients with a body mass index of 30 to 40. On the intragastric balloon for six months lose an average of 10-15 kg. Often in practice we encounter such a situation that in the fourth, and sometimes in the third month, patients contact us and inform us that they have already gained weight.

      This indicates ineffectiveness of further continuation of therapy on the intragastric balloon and is an indication for its removal.

      It is worth remembering that the installation of such a cylinder is only a temporary measure!

      Unfortunately, most patients regain weight after intragastric balloon removal without the constant support of a bariatric surgeon, rehabilitator, endocrinologist and trainer. For a stable result it is recommended to change your diet and lifestyle, once the balloon has been placed and the first results have been achieved, this will be much easier to do.

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        Results

        Before and after operations

        * photos posted with the permission of patients.