2023-07-04 09:30:02
The gastric balloon is a non-surgical technique that allows people who are overweight or moderately obese to gradually lose a few pounds. We talk regarding a minimally invasive technique because, unlike bariatric surgery, it does not require any incision. Once installed, the balloon occupies a good part of the stomach, which limits the amount of food that can be absorbed and accelerates the feeling of satiety. Who is this action for? How is the balloon introduced into the stomach? What are the post-operative consequences and possible complications? We take stock with two surgeons.
Definition: what is a gastric balloon?
The gastric balloon, also called intragastric balloon, is a medical device offered by some establishments to overweight or obese patients, as part of overall care. It is actually a inflatable balloon that are inserted into the stomach of patients to induce a feeling of early satiety and help them change their eating habits in order to lose weight.
Contrary to appearances, this device is temporary : it ceases to have effect and is removed following four to twelve months, depending on the balloon used and medical recommendations. “The said balloon is generally introduced into the stomach endoscopically, that is to say, passing through the mouth, esophagus and stomach using an endoscope, explains Dr. Foulatier, visceral and digestive surgeon. » Once in the stomach, it is filled with air or liquid, swells, and thus ends up occupying part of the stomach, reducing its capacity to contain food.
“It is important to emphasize what the gastric balloon is not a magic solution for weight loss ! “, underlines in turn Dr. Cracco, digestive and visceral surgeon. And to insist:
To be relevant, it must imperatively be part of a weight management program that includes appropriate dietary and sports guidelines, regular medical monitoring and psychological support.
What are the different types of intragastric balloons?
There are two main types of intragastric balloons:
Unmanageable polyurethane balloons, placed under X-ray control for four to six months. Their particularity? They disintegrate on their own and are eventually eliminated by natural means.And soft silicone balloons, placed under endoscopy, which remain in place between six and twelve months. More durable than polyurethane balloons, however, they require a second intervention to be removed. And as the French National Society of Gastroenterology (SNFGE) reminds us, “exceeding the deadline for removing the balloon exposes you to serious medical complications » (source 1).
What alternatives to promote weight gain in case of obesity?
As our experts remind us, the installation of a gastric balloon is not not validated by the High Authority for Health (HAS) which considers that the evidence of long-term efficacy is not satisfactory. On the other hand, they recognize that this device can be a gateway to one of the three recognized bariatric surgery operations: the bypassl’Gastric Band or the sleeve gastrectomy.
Indications: who has the right to the gastric balloon?
The gastric balloon is accessible for adults who are overweight or moderately obese who request it because they are unable to lose weight the conventional way (diet, exercise, lifestyle, etc.) and are not eligible for bariatric surgery – or do not wish to have it.
Eligibility requirements may vary from institution to institution, but the general rule is and IMC between 27 kg/m² and 35 kg/m², associated with one or more comorbidity(ies) likely to be improved by wearing the ball. “Beyond 35 kg/m², patients should rather benefit from surgical management”, insists Dr. Foulatier.
What are the contraindications to the pose of a ball?
Several physiological and / or psychological disorders can contraindicate the placement of a gastric balloon:
of the gastric lesions or disorders (history of gastric surgery, large hiatal hernia, untreated peptic ulcers, untreated inflammatory diseases, recurrent gastrointestinal bleeding, etc.); unstabilized underlying diseases (heart failure, kidney failure, hepatic cirrhosis, blood clotting disorders, cancer, etc.); psychiatric disordersand alcoholism, substance addiction ;of the eating disorders (bulimia or anorexia nervosa); inability or one refusal of prolonged medical follow-up ;the prolonged use of anti-inflammatories, anticoagulants or corticosteroids ;a severe liver disease.a pregnancy or a desire for pregnancy ;etc.
How to insert or remove a gastric balloon?
The polyurethane balloon requires neither endoscopy nor anesthesia: patients are placed under radiographic control and simply swallow a capsule connected to a catheter. Once this capsule has arrived in the stomach, it is filled with saline or air through said catheter. The amount of liquid or air injected varies with each person, but regardless, the balloon disintegrates following four to six months before being eliminated through the stool.
The flexible silicone balloon is placed by endoscopy under general anesthesia. First, the expert performs a control endoscopy: he/she inserts a flexible tube equipped with a mini-camera from the patient’s mouth to their stomach, which allows him/her to to confirm the absence of lesion(s) in the esophagus, due to the digestive tract and/or the stomach. The balloon is then placed in the gastric cavity and filled via a catheter under endoscopic control. It is removed a few months later, using the same procedure.
Note: each of these interventions lasts on average a half hour. And on the practical side, the installation and removal of the silicone balloons require you to be on an empty stomach. for at least 6 hours. In addition, patients must adopt a liquid diet a few days before each intervention.
Can you be fat and healthy?
Aftermath of the intervention: what to expect?
Once the balloon is installed, the patients are placed under postoperative surveillance for a few hours. Most often the intervention is performed on an outpatient basisbut if necessary, in the absence of immediate complications, hospitalization does not last more than 24 hours.
In the days or even weeks that follow, patients may feel some digestive discomfort. Abdominal pain, nausea and uncontrollable vomiting often occur at the start of treatment and fade during the first postoperative week. To limit the damage, be sure to stay well hydrated and do not hesitate to consult your doctor to benefit from antiemetic drugs.
Either way, you must adhere to strict medical monitoring as long as the balloon is in your stomach. In the program ? Check-up appointment with the expert in charge of supervision, consultations with a nutritionist, supervised sports sessions and psychological support.
After the removal of the balloon, there is no question of going back to your old habits: obesity is a recurrent multifactorial disease which requires lifelong follow-up!, reminds Dr. Cracco once more.
Gastric balloons: what are the disadvantages and risks?
The installation of a gastric balloon is not without risk. The most common complications according to the French National Society of Gastroenterology are:
Of the nausea (72% of cases), abdominal pain (50%) and vomiting (39 %), which, in 4 to 8% of cases, can lead to hospitalization, or even early removal of the balloon in the event of dehydration.gastroesophageal reflux and sometimes a secondary esophagitis.Of the food blockages.Of the complications related to anesthesia or endoscopy (bloating, throat irritation, abdominal cramps). lower effectiveness of oral contraceptives due to repeated vomiting at the start of treatment. Not to mention that in the absence of follow-up, weight loss is often less and the placement of the balloon ends in failure which discourages the patients.
There are also much rarer complications:
A obstruction of the esophagus by the balloonwhich requires an endoscopy very quickly to be able to remove the balloon, or even surgery. growth of bacteria inside the balloonwhich increases the risk of infections. migration of the balloon, which can cause bowel obstruction.A esophageal rupture.A gastric perforation.A pancreatitis.Of the difficulty removing the ball when the time comes, which may require gastric surgery.
In summary, quickly contact the team that treated you in the event of unusual abdominal pain; frequent and consistent vomiting, or even the discovery of a pregnancy!
“In my opinion, the arrival of new GPL-1 analogue drugs, used in particular in the treatment of type 2 diabetes, might soon compete with the gastric balloon, and even the endosleeve in the years to come. We know today that they are just as effective in promoting weight gain and that they induce much less risk,” says Dr. Foulatier.
Gastric balloon how many pounds can you lose?
“The average weight loss is, in studies, 17.8 kg. But the results remain heterogeneous and this weight loss is maintained over the long term in 20 to 30% of cases », Answers the French National Society of Gastroenterology (source 1).
In reality, it is useless to fixate on the number of pounds lost. The important thing is to start a weight management process to improve overall health and maintain a stable weight thanks to the adoption of a new way of life in the long term!
Price and reimbursement: what is the cost of a gastric balloon? Is it reimbursed by social security?
Placing a gastric balloon costs around 3000 euro and is not not covered by health insurance. Also count a few hundred extra euros if you have opted for a silicone balloon requiring removal. Before committing yourself, do not hesitate to contact your mutual insurance company in case it can cover part of the costs.
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