Intragastric Balloon Placement for Weight Loss
Intragastric Balloon Placement: The balloon consists of a silicon elastomer based material that is soft and pliable. Deflated balloon is inserted through the mouth and brought down through the esophagus until it reaches the stomach using an endoscope. A local anesthetic is applied to aid the passage through the esophagus. The endoscopy is performed under mild anesthesia.
On reaching the stomach, the balloon is then filled with saline solution colored in blue through a catheter attached to the balloon. This decreases the amount of stomach space. The balloon has a self-sealing valve which prevents the liquid from leaking.
The balloon is then left in the stomach up to a period of around 6-8 months. Intragastric balloon placement is proven effective in bringing an average weight loss of around 10-15 kg within 6-8 months. It is generally used in overweight and obese patients. The aim of a gastric balloon is to cause a feeling of fullness of stomach and to reduce hunger. It also reduces the appetite hormone – Ghrelin.
The entire length of the procedure is around 20 minutes. The patient will be monitored in the hospital for 24 hours before discharge.
It should be noted that placement of intragastric balloon is not a permanent weight loss procedure. The placement of the balloon is for a brief period of time around 6-8 months after which it is mandatory to remove the balloon.
The main indications for placement of intragastric balloon (IGB) are:
- Patients with BMI 25 – 32.
- Obesity Class II (BMI 32-37) patients in whom surgery is not indicated. This could be due to patient’s reluctance to undergo surgery or due to other medical conditions.
- In morbidly obese (BMI > 37) patients, IGB placement may be performed before bariatric surgery to reduce surgical morbidity.
- Intragastric balloon is also performed in patients with BMI between 23 – 25 who is suffering from medical conditions like PCOD (Polycystic Ovarian Disease) or Infertility, and who have failed to reduce weight with dietary measures.
Evaluation before the Procedure
- Hemogram, RBS, HbA1C
- Liver function test, Lipid Profile, Thyroid function test, Renal function test
- ECG, X-Ray Chest PA, USG abdomen.
What to expect after Intragastric Balloon Placement?
Common symptoms during the initial days post insertion of the balloon are nausea, vomiting, abdominal pain, acid reflux. Medications will be prescribed to minimize these symptoms. To prevent dehydration, frequent intake of water may be necessary.
You have to have food as prescribed by the dietician. Some patients take a light meal. A consultation (in person or by phone) every month will be scheduled. The consultations help to assess the progress of weight loss.
A dietician will prescribe the diet to be followed. Nutritional and behavioral modification is important after the removal of the balloon to ensure the body remains fit and no excess weight is gained.
Withdrawal of the Balloon
Intragastric balloon is placed for a period of 6 – 8 months after which it is removed. The stomach gets adapted to it and the balloon may no longer be effective. It may become important to remove the balloon early in case of spontaneous rupture of the balloon or in cases where the patient is not tolerating the balloon at all – though the incidences of these are very, very rare.
The balloon is first punctured to deflate it, and then is removed through the esophagus and out of the mouth. This is also performed under mild general anesthesia with the guidance of endoscope. The procedure takes around 15 minutes. The patient can go home the same day.
Cost of Intragastric Balloon Placement
All together package expenses for IGB insertion may be 1.4 to 1.5 lakhs and removal will cost Rs. 30,000/-