Manoel Galvao Neto1, Lyz Bezerra Silva2, Eduardo Grecco3, Luiz Gustavo de Quadros3, André Teixeira4, Thiago Souza3, Jimi Scarparo5, Artur A Parada6, Ricardo Dib3, Rena Moon7, Josemberg Campos2. 1. 9 de Julho Hospital, São Paulo, Brazil; Florida International University, Miami, Florida; Federal University of Pernambuco, Recife, Brazil. 2. Federal University of Pernambuco, Recife, Brazil. 3. ABC Medical School, Mário Covas State Hospital, São Paulo, Brazil. 4. Orlando Regional Medical Center, Orlando Health, Orlando, Florida. Electronic address: andre.teixeira@orlandohealth.com. 5. Scarparo Scopia Clinic, São Paulo, Brazil. 6. 9 de Julho Hospital, São Paulo, Brazil. 7. Orlando Regional Medical Center, Orlando Health, Orlando, Florida.
Abstract
BACKGROUND: Intragastric balloons (IGBs) are a minimally invasive option for obesity treatment, acting as a space-occupying device and leading to weight loss through increased satiety. This device has been growing in popularity owing to its safety profile and good weight loss results. However, there are no published guidelines that standardize the technical aspects of the procedure. OBJECTIVES: To create a practical guideline for intragastric balloon usage. SETTING: Private and Academic Settings, Brazil. METHODS: A consensus meeting was held in São Paulo, Brazil, in June 2016, bringing together 39 Brazilian endoscopists with extensive experience in IGBs from all regions of the country. Topics on patient selection, indications, contraindications, multidisciplinary follow-up, technique, and adverse events were discussed in the form of questions. After electronic voting, a consensus was defined when there was ≥70% agreement. Experts were also requested to provide data on their experience with IGBs. RESULTS: The selected experts discussed and reached a consensus on 76 questions, mainly concerning specific indications and contraindications for the procedure; technical details, such as patient preparation, minimum balloon-filling volume, techniques for implant and explant; patient follow-up and recommended medication for the adaptation period; and adverse event management. The overall Brazilian expert data encompassed 41,863 IGBs, with a mean percentage total weight loss of 18.4% ± 2.9%. The adverse event rate after the adaptation period was 2.5%, the most common being hyperinflation (.9%) and spontaneous deflation (.8%) of the device. The early removal rate due to intolerance was 2.2%. CONCLUSIONS: The present consensus represents practical recommendations for performing IGB procedures and reflects Brazil's significant experience with this device. The experience of over 40,000 cases shows that the device leads to satisfactory weight loss with a low rate of adverse events.
BACKGROUND: Intragastric balloons (IGBs) are a minimally invasive option for obesity treatment, acting as a space-occupying device and leading to weight loss through increased satiety. This device has been growing in popularity owing to its safety profile and good weight loss results. However, there are no published guidelines that standardize the technical aspects of the procedure. OBJECTIVES: To create a practical guideline for intragastric balloon usage. SETTING: Private and Academic Settings, Brazil. METHODS: A consensus meeting was held in São Paulo, Brazil, in June 2016, bringing together 39 Brazilian endoscopists with extensive experience in IGBs from all regions of the country. Topics on patient selection, indications, contraindications, multidisciplinary follow-up, technique, and adverse events were discussed in the form of questions. After electronic voting, a consensus was defined when there was ≥70% agreement. Experts were also requested to provide data on their experience with IGBs. RESULTS: The selected experts discussed and reached a consensus on 76 questions, mainly concerning specific indications and contraindications for the procedure; technical details, such as patient preparation, minimum balloon-filling volume, techniques for implant and explant; patient follow-up and recommended medication for the adaptation period; and adverse event management. The overall Brazilian expert data encompassed 41,863 IGBs, with a mean percentage total weight loss of 18.4% ± 2.9%. The adverse event rate after the adaptation period was 2.5%, the most common being hyperinflation (.9%) and spontaneous deflation (.8%) of the device. The early removal rate due to intolerance was 2.2%. CONCLUSIONS: The present consensus represents practical recommendations for performing IGB procedures and reflects Brazil's significant experience with this device. The experience of over 40,000 cases shows that the device leads to satisfactory weight loss with a low rate of adverse events.
Authors: Kamal K Mahawar; Jacques M Himpens; Scott A Shikora; Almino C Ramos; Antonio Torres; Shaw Somers; Bruno Dillemans; Luigi Angrisani; Jan Willem M Greve; Jean-Marc Chevallier; Pradeep Chowbey; Maurizio De Luca; Rudolf Weiner; Gerhard Prager; Ramon Vilallonga; Marco Adamo; Nasser Sakran; Lilian Kow; Mufazzal Lakdawala; Jerome Dargent; Abdelrahman Nimeri; Peter K Small Journal: Surg Endosc Date: 2019-06-19 Impact factor: 4.584
Authors: Eric J Vargas; Fateh Bazerbachi; Andrew C Storm; Monika Rizk; Andres Acosta; Karen Grothe; Matt M Clark; Manpreet S Mundi; Carl M Pesta; Ahmad Bali; Eric Ibegbu; Rachel L Moore; Vivek Kumbhari; Trace Curry; Reem Z Sharaiha; Barham K Abu Dayyeh Journal: Obes Surg Date: 2019-12 Impact factor: 4.129