OBESITY SURGERY

Gastric Balloon

One of the most common health problems worldwide, obesity is characterized by excessive fat accumulation in the whole body, especially in the subcutaneous parts and abdominal cavity. During the evaluation of the degree of obesity, measurements such as body mass index, belly circumference, and hip/height ratio are used for each patient.

People with a body mass index value between 30 and 40 are called obese, and people with a body mass index of 40 and above are called morbidly obese. People with morbid obesity are at higher risk of experiencing problems such as hypertension, endocrine disorders, psychiatric problems, cardiovascular diseases, skeletal system problems, and sleep apnea. Therefore, morbid obesity is a health problem that must be treated.

Since obesity is a health problem that causes significant problems in all systems, especially in endocrine and cardiovascular diseases, the use of different methods for treatment is on the agenda. It is not always possible to achieve the desired results in weight loss through regular diet, exercise, and medication. In addition, one of the most common problems encountered by obesity patients is the inability to maintain their diet. The most important reason underlying this is the patient’s feeling of hunger and the failure to feel full. One of the methods used to solve these problems is the gastric balloon procedure.

What Is Gastric Balloon?

Gastric balloon, i.e. endoscopic intragastric balloon, is a non-surgical obesity treatment method that is frequently used all over the world. Gastric balloon is a silicone balloon that, after placed in the patient’s stomach, can be inflated until it reaches volumes ranging from 400 to 700 cc using liquid or air. Takes up space in the stomach, the balloon gives the patient a feeling of fullness, and the purpose of this method is to control obesity. Gastric balloon is positioned among more complicated bariatric surgical procedures only with diet and exercise alone, and it is a frequently used method in overweight and obese people who are not within the surgical margin. Since the gastric balloon procedure can be applied in preparation for bariatric surgery, it helps to lose excess weight quickly.

Today, there are different types of gastric balloons that can be preferred to use. The main feature of all gastric balloons that can be filled with serum or air is that they create a mass effect in the patient’s stomach and create the desired effect by creating a feeling of fullness. Gastric balloons are generally produced to withstand stomach acid for 6 months.

Gastric balloon is one of the temporary weight loss methods for patients. The method, which can be applied without any incision in the stomach, reduces the amount of food taken by the patient’s stomach. The air-filled balloon occupies a certain place in the stomach, thus reducing the stomach’s capacity to take nutrients. As a result, although the patient consumes food in smaller portions, when they start to feel full, their energy needs are met through the use of stored fat in the body.

After the gastric balloon procedure, patients should reduce the size of their portions and reduce their eating frequency. One of the most important factors that accelerate the weight loss process is to eliminate the need and habit of snacking between meals. After an average of 6 to 12 months after the gastric balloon application, it is possible to significantly regress in the patient’s diseases such as metabolic syndrome, diabetes, triglyceride, gout, and cholesterol.

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How is Gastric Balloon performed?

If you are eligible for gastric balloon treatment, you are primarily injected with an effective drug of sedation and general anesthesia. The duration and capacity of the action of this drug cocktail is not as intense and severe as in normal surgical operations. It is used to put you to sleep until the stomach balloon application is completed. Since the application is performed within 15 to 20 minutes, the duration of the effect is also this. After administration of drugs, it is lowered to the stomach via an Endoscopic Camera. After examining the stomach with an endoscopic camera, including the areas up to the stomach, if there is no problem, the stomach balloon is placed. The placed stomach balloon is inflated with air or water (depending on the type). The procedure is so simple and easy that there is no risk other than side effects and various simple – short-term complications. These side effects and complications are nausea, stomach pain and vomiting, which can occur for a short time after the stomach balloon is inserted. It may not be observed in every individual, it may not be of the same severity. You can get rid of these effects within a few days by giving the necessary medications.

 

 

Depending on the type and capacity of gastric balloons, there are periods of stay in the stomach. But usually 6-month-old varieties are used. During this time, you will be full by consuming small portions within the framework of the opportunities offered by the stomach balloon, and your feeling of satiety will be long. For this reason, after installing a stomach balloon, you should give up your unhealthy eating habits. Go to a healthy diet by following the diet lists provided by a dietitian. You can drop up to 20 – 30 pounds with the application of a stomach balloon. Increasing and reducing this ratio is entirely in your hands. There is no guarantee of weight loss in gastric balloon treatment. Although the stomach balloon is attached, you will not be able to lose enough weight if you continue your old unhealthy food habits. Patients who will be fitted with a stomach balloon should not eat at least 12 hours before Administration and should not drink anything, including water, at least 6 hours before Administration. After the procedure, you just need to stay in the hospital for 1-2 hours.

How is the Gastric Balloon Applied?

The gastric balloon procedure is performed endoscopically after the patient is administered general anesthesia or sedation. The patient does not feel any pain during the application. The light camera, called an endoscope, with an average thickness of 0.8 to 1.2 mm, passes easily through the patient’s esophagus thanks to its flexible structure. The entire upper system of the patient from the esophagus to the duodenum is examined, and necessary controls are made. If no ulcer, reflux, severe gastritis, or suspicious lesion is observed in the stomach, the endoscope is removed, and the balloon is sent into the stomach.

The next step is the gradual filling of the gastric balloon by observing it with the endoscope. The gastric balloon is filled with saline to which an ink-like dye called methylene blue has been added. Thus, if there is any leakage in the balloon, the patient notices a color change in their urine or stool and consults to their doctor. After the balloon is sufficiently inflated, the endoscope is removed, and the procedure is complete. 

The gastric balloon procedure is completed within an average of 20 minutes. Under normal circumstances, patients who have undergone the gastric balloon procedure are discharged from the hospital after being observed for several hours. After gastric balloon application, the patient may experience cramping, vomiting, and nausea for several hours as the stomach tries to digest the balloon. 

The patient should follow a clear liquid diet on the day of gastric balloon application and the day following the application. For this, a two-day liquid diet is started after the placement of the gastric balloon. In order to monitor the reactions of the stomach to nutrition, the consumption of soft and pureed foods is started on the seventh day of the gastric balloon application. In cases where no discomfort occurs, the patient gradually starts consuming solid food on the fifth day. 

It is necessary for patients who have undergone gastric balloon procedure not to consume liquid 30 minutes before and after meals to prevent possible enlargement of the stomach. One of the most important factors facilitating the process of accepting the gastric balloon is eating less. In addition, carbonated drinks, harmful snacks, refined sugar, and alcohol should be avoided. Meals should be eaten very slowly and thoroughly chewed. 

Every day, 3 main meals and 3 snacks should not be skipped, at least 1.5 liters of water should be consumed per day, but liquids should not be consumed with meals. Water and other drinks should be drunk before or after meals. Eating and drinking should be stopped at least 2 hours before going to bed, care should be taken not to eat too late, and care should be taken to exercise for at least 40 minutes every day. Carbonated drinks and strong coffee should be avoided.

Is Gastric Balloon Risky?

Gastric balloon is an endoscopic and temporary method applied for patients who cannot lose the targeted weight despite regular diet and exercise, who have a high risk of surgery, or who do not prefer surgical procedures.

If the gastric balloon procedure is applied to the patient with the right techniques after the evaluations made, there will be no risky situation for the patient. Since it is an endoscopic method, it is known that the possible risks are extremely low, unlike surgical procedures.

On the other hand, although rare, risks such as anesthesia, bleeding, leakage, bursting, nausea, abdominal pain, and vomiting may occur after the gastric balloon procedure.



Who is Eligible for Gastric Balloon?

There is no basic weight restriction sought for patients for the application of the gastric balloon procedure. Although it is possible to apply the gastric balloon method to people with a body mass index of 27 and above, who cannot lose weight with regular diet and exercise, the decision of suitability for the procedure is made after the evaluations made for each patient.

Gastric balloon can be applied to people:

  • Who have a body mass index of 27 and above;
  • Who are genetically predisposed to diabetes;
  • Whose general health status is at risk due to their excess weight;
  • Who cannot lose weight naturally or regain their lost weight in a short time;
  • Who have not had stomach surgery before;
  • Who need to lose weight quickly before gastric sleeve surgery;
  • Who are not suitable for bariatric surgery procedures due to their health condition.

However, if the patient has health problems such as reflux, ulcer, and large gastric hernia, the gastric balloon procedure cannot be applied. Gastric balloon method is not applicable to patients who have undergone bariatric surgery before, those who are pregnant or planning a new pregnancy, those who have psychological problems or alcohol addiction, and those who have problems in the esophagus.

Is Gastric Balloon Permanent?

Gastric balloon is a temporary method used in the treatment of obesity. The gastric balloon is removed an average of 6 months to 1 year after placement with the endoscopic method. Endoscopic method is also used during the removal of the gastric balloon. After the liquid in the balloon is drained using a special apparatus, the gastric balloon is caught and removed with the help of a special holder. 

Since there is no surgical procedure in the gastric balloon procedure and the procedure is performed endoscopically, patients do not need a long recovery period.  Thus, patients can continue their daily lives after gastric balloon application. 

Although there is no change in the way the stomach and other organs and systems work, the patient’s feeling of eating can be reduced thanks to the space occupied by the balloon placed in the stomach. In order for patients to get rid of their excess weight in a healthy way after the operation, healthy eating and regular exercise should become a lifestyle habit. 

When the gastric balloon is removed from the stomach 6 to 1 years after it is placed, the stomach regains its original shape. During this period, it is very important for the patient to adopt the right lifestyle habits to ensure weight control. However, in cases where the patient cannot reach the desired weight target after the gastric balloon is removed, the procedure may be repeated again.



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