Intragastric Balloon for Management of Severe Obesity: a Systematic Review

Abstract

Older models of intragastric balloons (IGBs) had unacceptably high complication rates and inconsequential weight loss. With FDA approval of newer models, we aimed to systematically examine the literature regarding the efficacy of IGB therapy for obesity. A comprehensive electronic database search was completed. Title searching was restricted to the following keywords: bariatric, gastric, gastric bypass, gastric band, sleeve gastrectomy, and intragastric balloon. Twenty-six primary studies (n = 6101) were included. At balloon removal, mean change in weight and BMI were 15.7 ± 5.3 kg and 5.9 ± 1.0 kg/m(2). The most common complications were nausea/vomiting (23.3 %) and abdominal pain (19.9 %). Serious complications were rare: mortality (0.05 %) and gastric perforation (0.1 %). IGBs are associated with marked short-term weight loss with limited serious complications.

Endoscopic bariatric and metabolic therapies: Another tool for the management of diabetes and obesity

“…Most of the literature on the safety of IGBs focuses on the Bioenterics Intragastric Balloon (BIB; Apollo Endosurgery), which is marketed as the Orbera system in the US. Multiple meta‐analyses have been published since BIB inception, with consolidated data of complication rates, which are overall low and tend to be mild in nature . Early complications of BIB placement caused by the space‐occupying nature of the balloon include abdominal pain, nausea, vomiting, heartburn, and dyspepsia.…”

“…Early complications of BIB placement caused by the space‐occupying nature of the balloon include abdominal pain, nausea, vomiting, heartburn, and dyspepsia. In a systematic review of 26 studies (n = 6101) published between 1946 and 2015, it was found that as many as 23.3% of patients experienced nausea and vomiting and 19.9% of patients experienced abdominal pain . Yet another systematic review reported that abdominal pain and nausea occurred in 33.7% and 29% of subjects after Orbera implantation, respectively .…”

“…Some of the most feared serious adverse events are related to balloon migration causing mechanical obstruction. The rate of balloon deflation with displacement has been reported to be 2.5% or less in multiple meta‐analyses, and subsequent gastric outlet or intestinal obstruction was reported to be less than 1% . Gastric perforation (<1%) was an important cause of morbidity, but mostly occurred in patients with a previous history of gastric surgery .…”

“…Gastric perforation (<1%) was an important cause of morbidity, but mostly occurred in patients with a previous history of gastric surgery . Death was rare, with few reported mortalities secondary to gastric perforation . Many of these events were seen in patients that had the balloon removed after the recommended 6‐month period and were lost to follow‐up …”

Response to Letter to the Editor: Intragastric Balloon for Management of Severe Obesity: a Systematic Review

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Dear editor, Please consider these comments in response to the Letter to the Editor submission raising concerns about our recently published article by Yorke et al, BIntragastric balloon for management of severe obesity: a systematic review [1].Ŵ e appreciate the interest taken to our article and acknowledge the peer-reviewed critique. Our paper reflects the issue of bridging morbidly obese patients to definitive bariatric surgery with the placement of intragastric balloons (IGB).

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