The placement of a gastric balloon is a non
invasive and temporary procedure for treating obesity. It is known for thirty
years, and used to be very popular in the United States in the eighties.
Then it has been discarded owing to poor results, and again used for
a decade with a more reliable device (INAMED, USA). However there is no hype
because of occasional unsatisfactory and temporary results.
Long-term results were eagerly expected, in order to answer the primary
question: once a weight-loss has been obtained from an endoscopically placed
balloon, is it possible to maintain it after it has been removed? One of the
most experimented team worldwide has now released its data in a recent
paper*.
In Belgique (area of Liege) 100 consecutive patients (77 F, 23 M) had a
gastric INAMED balloon implanted and filled with 500 cc of saline serum. This
took place between March 2000 and March 2002, and the patients were followed up
to one year after the balloon had been taken out. Although the manufacturer
recommends that the balloon should not stay beyond six month, many patients (48)
kept it after a period of 10 months, with a mean overall duration of 9,9 months.
Mean pre-operative weight has been 96 kg, and mean Body Mass Index 34 kg/m2 (25
to 60). Adverse effects of the balloon have been mainly nausea and vomiting (two
thirds of the patients in the days following the procedure, and one third during
the entire duration of implant).
No severe complication has been reported, but 20 patients had significant
oesophageal inflammation (oesophagitis) at the endoscopy check before removal.
At the time of removal, the mean weight-loss has been 12 kg, and the average
excess-weight has been 40%. One year after the balloon had been taken out the
losses were 8,6 kg and 27%, which is satisfactory if compared with conventionnal
treatments of obesity (diet). Nevertheless, 44 patients had an unsatisfactory
result. We therefore assume that gastric balloon is not suitable for any obese
patient...