BioEnterics Intragastric Balloon for Treatment of Morbid Obesity in Prader–Willi Syndrome: Specific Risks and Benefits

Peppo, Francesco De; Giorgio, G. Di; Germani, Micaela; Ceriati, Emanuela; Marchetti, P.; Galli, Carlo; Ubertini, M. G.; Spera, S.; Ferrante, Giuseppe; Cuttini, Marina; Cappa, Marco; Gattinara, Guido Castelli; Rivosecchi, M.; Crinò, Antonino

doi:10.1007/s11695-008-9509-8

Cited by 38 publications

(33 citation statements)

References 27 publications

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“…Therefore, intragastric balloon therapy is regarded to be more appropriate for patients with relatively mild obesity. Previous reports showed that 2 consecutive balloon therapies (6) and repeated balloon therapies (7) achieved good results after 12 months of treatment, and multiple balloon therapies were effective maintenance treatment to control body weight in Prader-Willi syndrome patients when treatment was started in early childhood (8).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Repeated Intragastric Balloon Therapy in a Morbidly Obese Japanese Patient

et al. 2011

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A 19-year-old Japanese male with a BMI of 55.4 kg/m 2 who also had liver dysfunction, dyslipidemia and hyperuricemia underwent repeated intragastric balloon therapy. The percent excess weight loss was 22.5% at the first balloon removal and 28.6% at the second balloon removal. The hepatic dysfunction resolved after the second balloon therapy, however, the dyslipidemia and hyperuricemia did not improve. The Japanese population is regarded as a high-risk race for obesity-related diseases at lower BMI values, and morbidly obese Japanese patients may need more serious weight reduction protocols to improve the comorbidities than similarly obese Americans or Europeans.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Repeated Intragastric Balloon Therapy in a Morbidly Obese Japanese Patient

et al. 2011

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“…Attempts are undertaken to use the balloons in various disease entities related to obesity [6][7][8]. Similarly to other medical tests, the balloon insertions can also be followed by complications.…”

Section: Discussionmentioning

confidence: 99%

Gastric Perforation as a Complication after BioEnterics Intragastric Balloon Bariatric Treatment in Obese Patients—Synergy of Endoscopy and Videosurgery

Śmigielski

Szewczyk²,

Modzelewski³

et al. 2009

OBES SURG

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The BioEnterics intragastric balloon (BIB) is one of the most common bariatric procedures in obese patients in Europe. Associated gastric perforation is a rare, yet very dangerous, complication. We report a case of such a complication after BioEnterics intragastric balloon insertion in a 60-year-old female patient and subsequent cooperation between an endoscopist and bariatric videosurgeon in her treatment.

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“…We also agree with the concept that obesity should be primarily prevented and treated with supervised reduced-energy diets, restricted access to food, and daily exercise regimen [2].When pharmacological, dietary, and behavioral approaches fail, however, to control body weight and obesity is progressive and severe (body mass index (BMI) over 40)-as occurs in patients not followed since birth or those referred when the obesity is already severe-the use of Bioenterics Intragastric Balloon (BIB) may represent an alternative and effective treatment for body weight control [3].In our study [4], younger patients appeared to benefit from treatment more than their older peers, and in the two youngest patients treated more than once, a substantial BMI reduction was maintained during a treatment period of 3 years. In one patient (12.4 years), we were able to maintain a satisfactory BMI control until the age of 17, when he underwent a successful biliopancreatic diversion.…”

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confidence: 91%

Bioenterics Intragastric Balloon May Represent an Alternative and Effective Treatment for Body Weight Control in Prader–Willi Syndrome

et al. 2009

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To the editor: We agree with the comment of Scheimann and colleagues [1] regarding the difficulties on treating obesity in PraderWilli syndrome (PWS). We also agree with the concept that obesity should be primarily prevented and treated with supervised reduced-energy diets, restricted access to food, and daily exercise regimen [2].When pharmacological, dietary, and behavioral approaches fail, however, to control body weight and obesity is progressive and severe (body mass index (BMI) over 40)-as occurs in patients not followed since birth or those referred when the obesity is already severe-the use of Bioenterics Intragastric Balloon (BIB) may represent an alternative and effective treatment for body weight control [3].In our study [4], younger patients appeared to benefit from treatment more than their older peers, and in the two youngest patients treated more than once, a substantial BMI reduction was maintained during a treatment period of 3 years. In one patient (12.4 years), we were able to maintain a satisfactory BMI control until the age of 17, when he underwent a successful biliopancreatic diversion.BIB, as a totally reversible and repeatable technique, can be used more than once to allow pediatric patients to reach adult age maintaining their BMI as close as possible to normal values. In older patients, BIB can be useful as a preliminary treatment to reduce the risks of a definitive bariatric surgical procedure.Serious complications in BIB appear when a specific postoperative management protocol is not followed. In our experience, all major complications occurred at the beginning of the study as a consequence of the lack of a specifically designed dietary protocol and strict postoperative monitoring. Once this postoperative protocol has been adopted, the complication rate has been significantly reduced and no serious adverse events were observed. With this new protocol and the extensive experience that we now have in our Institute, we have inserted ten BIB over the last 2 years, without any significant complications (data not published).In conclusion, our experience clarifies that to reduce the risk of serious adverse events after BIB, careful selection of patients and families followed by adequate follow-up after implantation is required. Considering that individuals with PWS have an underlying defect in satiety, altered pain threshold, and a decreased ability to vomit with the possibility of gastric rupture [5], a specific postoperative protocol of management must be always adopted, including close postoperative monitoring. Finally, we consider BIB a valid alternative treatment of body weight control only when pharmacological, dietary, and behavioral approaches have failed and obesity is progressive and severe.

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BioEnterics Intragastric Balloon for Treatment of Morbid Obesity in Prader–Willi Syndrome: Specific Risks and Benefits

Cited by 38 publications

References 27 publications

Effectiveness of Repeated Intragastric Balloon Therapy in a Morbidly Obese Japanese Patient

Effectiveness of Repeated Intragastric Balloon Therapy in a Morbidly Obese Japanese Patient

Gastric Perforation as a Complication after BioEnterics Intragastric Balloon Bariatric Treatment in Obese Patients—Synergy of Endoscopy and Videosurgery

Bioenterics Intragastric Balloon May Represent an Alternative and Effective Treatment for Body Weight Control in Prader–Willi Syndrome

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