Endoscopic intragastric balloon as a bridge to bariatric surgery for the management of a superobese patient
Epublication WebSurg.com, Oct 2011;11(10). URL: http://websurg.com/doi/vd01en3440
The use of an air-filled intragastric balloon is effective in achieving a relevant loss of body weight. It is used as a bridge to definitive surgery in superobese patients for whom surgery is often associated with high risks. The balloon helps reduce the volume of the stomach and leads to a premature feeling of satiety. These endoscopic bariatric bridging procedures can reduce the overall risk related to the surgical intervention, as measured by the use of the American Society of Anesthesiologists Physical Status Classification System, and promote cardiopulmonary and metabolic improvement. By reducing truncal/visceral obesity, these endoscopic bariatric procedures can ease off technical difficulties related to subsequent surgical interventions. In this video, we show the case of a 44-year-old superobese man with a BMI of 63, presenting with diabetes mellitus and obstructive sleep apnea, in which a Heliosphere® BAG Pre OP balloon was positioned with the objective of weight reduction. The procedure is performed under general anesthesia with orotracheal intubation, and with the patient in supine position. Upper endoscopy did not show any lesions or any contraindications to the gastric balloon implantation. All the procedure is carried out under endoscopic control. In retroversion, good positioning of the inflated balloon is controlled at the level of the fundus floating freely. PPI drugs are administered throughout the procedure. The patient is discharged on postoperative day one after starting a liquid diet, and on the following day, he is on a normal hypocaloric diet. The patient is scheduled to have the Heliosphere® BAG Pre OP removed within six months.