Is Surgery For You?
Laparoscopic Roux-y-gastric bypass (LRYGB)
Laparoscopic Adjustable Gastric Band (LAGB)
Laparoscopic Mini-gastric bypass (LMGB)
Laparoscopic Sleeve Gastrectomy (LSG)
Laparoscopic Greater Curvature Plication (LGCP)
Biliopancreatic Diversion (BPD)
Revisional Bariatric Surgery
Endoscopic Gastric Balloon
Endoscopic Gastric Balloon
The balloon is placed inside the stomach with the guidance of an endoscope, which is a long tube with a camera at the end that would allow the surgeon to see inside the esophagus and stomach. It is done with the patient under heavy sedation but not general anesthesia. The balloon is inserted in the stomach and then filled with a salt-water solution at a size ranging from 500 to 700 ml. A Blue dye (Methylene Blue) is added to the solution to color it. This procedure is best suited for a patient who:
is not physically fit for major surgery at all
needs to lose weight to make further surgery safer
is unable to lose weight with the regular ways but does not want to have surgery
Weight loss after the intra-gastric balloon is not as dramatic as with bariatric surgery. The expected weight loss is around 8-15 kgs over 6 months. The balloon has to be removed within 6 months to minimize the risk of small intestinal blockage. Most patients will regain weight after balloon removal.
Risks and Side Effects
The placement of the balloon is very safe and the risks are uncommon but may occur. The most serious risk is hurting the esophagus causing a puncture (occurs at a rate of 1/500).
Side effects including nausea, vomiting, heartburn, chest pain, abdominal pain and may necessitate admission to the hospital for IV fluids and medications. They generally subside in 1-5 days.
There is a small risk that the balloon may spontaneously deflate and exit the stomach into the small intestines causing an intestinal obstruction. That is why we use the blue dye in the balloon so when the balloon gets punctured the blue dye is absorbed by the stomach lining and goes into the blood stream. The color of the urine becomes greenish alerting the patient to call the doctor so the balloon can be promptly removed.
Life after the Balloon
The average procedure takes about 30 minutes. Most patients go home shortly after but some require staying in the hospital at least 24 hours for intravenous fluids, pain killers and medications for nausea. The early phases of diet consist of clear liquids with gradual transition to full fluids and soft foods over 4 weeks.
It is important to use the balloon as a helping tool so the patient should take advantage of it and limit the intake of high caloric foods containing sugar and fat. He/she should start a graduated exercise program. The balloon needs to be removed at 6 months or less. It is also removed with the help of the endoscope under heavy sedation. The main risk of the balloon removal is injury to the stomach or esophagus.