Multidisciplinary Clinic of Metabolic & Bariatric Surgery

Weight Reduction Procedures

Laparoscopic Adjustable

Gastric Banding (LAGB)

Laparoscopic Sleeve

Gastrectomy

Laparoscopic Gastric

Bypass

Intragastric Balloon

(IGB) Program

Risk of Surgery

Who Need Surgery

Choice of Procedures

Metabolic Surgery

Life after Surgery

INTRAGASTRIC BALLOON (IGB) PROGRAM

What is Intra-gastric Balloon

The use of an intragastric balloon in the treatment of obesity and morbid obesity has been a well-known practice. The idea of using a gastric space-occupying volume device, giving a sensation of satiety, for the control of obesity was first described in 1982. However, in the mid 1980's, poorly designed balloons had numerous complications leading to spontaneous and early deflations, balloon displacement, and intestinal obstruction. Not until 1990's, a new type of intragastric balloon with improved design which offers numerous advantages and has become a clinically accepted method of treatment of obesity in Europe and south America.

IGB treatment program aims at behavioral modification of poor eating habit through sense of satiety created by IGB, together with dietetic supervision of low calorie meal during the 6 months treatment period. The use of the intragastric balloon in the treatment and management of morbid obesity is not a panacea; correct patient selection and respect of the dietetic and behavioral program are key factors in obtaining successful results. Experience in Hong Kong reviewed in average 10-12 kg of weight can be lost by IGB program. Nevertheless, after the removal of the balloon, weight-regain is possible. It is thus not a long-term solution of obesity and can never replace surgery in morbidly obese individuals. However, in selective group of patient who is not suitable for surgery, IGB program is a valid alternative in controlling the body weight.

How Is the Intragastric Balloon Placed in the Stomach?

The balloon is introduced into the stomach through the mouth without the need for surgery. The physician conducts an initial examination of the stomach using an endoscopic camera. If no abnormalities are observed, the physician proceeds with placement of the balloon through the mouth and down the oesophagus into the stomach. The balloon is made of a soft and pliable silicone material and is inserted while in its smallest, deflated form. The swallowing process is made easier with the help of anaesthetics applied topically to numb the throat area.

When the balloon is well within the stomach, it is filled with approximately 500cc of saline fluid. The procedure lasts approximately twenty minutes and is performed on an out-patient basis.

Who Can Join the IGB program?

In 2004, we established a new IGB program for those patents who is not suitable or do not consent for operative bariatric surgery. In this program, IGB therapy is used as a temporary weight control measure in three groups of patients:

1.	Patients who are surgical candidates and willing to receive bariatric surgery, but preoperative weight reduction is considered beneficial, especially in super-obese (e.g. BMI>60) individual.
2.	Patients who are candidates for bariatric surgery but unwilling to undergo major surgical procedure.
3.	Patients with BMI 25-32 who are not candidate for surgery but suffered from obese-related co-morbidities and had failed conservative weight reduction therapy in the past.

How Long Is the IGB Used?

The balloon currently can be used for six months. Longer periods of use are not recommended. Over time the acidic content of the stomach will weaken the balloon material and cause the balloon to deflate. After 6 months, the balloon is removed in the same way it was placed, via the oesophagus and mouth.

What Unpleasant Effects Are Possible with the IGB program?

1.	Severe nausea & vomiting - may occur immediate after placement of IGB. Some patients may require anti-emetic treatment during the first few days but it usually disappear within 1 week after placement.
2.	Dehydration - may result from stomach upset and reduce fluid intake. Some patients may require hospitalization for fluid replacement.
3.	Balloon deflation - spontaneous balloon deflation is uncommon (<5%) if it is remove within 6 months time. However, un-noticed deflation may lead to bowel obstruction and some patient may require operative treatment to removed the balloon and relief obstruction.

Will I Regain My Weight after the Intragastric Balloon Is Removed?
Because the balloon in the stomach creates a feeling of fullness, it acts as an aid to weight reduction and may help you to adhere to a prescribed diet. You will have a much greater chance of maintaining your weight loss after balloon removal if you maintain and improve the diet and behavior changes you made while using the balloon. In our experience, 30% of patients can maintain more than 10% of their lost weight in average of 12 months after balloon removal.