Maciej Patrzyk1, Jenny Sonke2, Anne Glitsch1, Rebecca Kessler3, Antje Steveling4, Sebastian Lünse1, Lars Ivo Partecke5, Claus-Dieter Heidecke1, Wolfram Kessler1. 1. Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany. 2. Department of Pathology, University Medical Center Greifswald, Greifswald, Germany. 3. Department of Diagnostic Radiology and Neuroradiology, University Medical Center Greifswald, Greifswald, Germany. 4. Department of Internal Medicine A, University Medical Center Greifswald, Greifswald, Germany. 5. Department of General, Visceral and Thoracic Surgery, Helios-Klinikum Schleswig, Schleswig, Germany.
Abstract
PURPOSE: The implantation of a gastric balloon (also known as intragastric balloon) is an established and reversible endoscopic procedure for adiposity therapy. Structural changes of the stomach wall are expected to occur with gastric balloon implantation; however, until now these changes have rarely been investigated. METHODS: We compared the histological structure of the stomach wall after gastric-sleeve resection in a group of patients following gastric balloon implantation and a group without previous gastric balloon implantation. RESULTS: Following gastric balloon implantation, the tunica muscularis was found to be significantly thicker than without gastric balloon implantation. The enlarging of the tunica muscularis is not caused by hyperplasia of the leiomyocytes, but by hypertrophy of the leiomyocytes and an increase in collagen fibers (fibrosis). CONCLUSION: A longer-lasting hypertrophy of the tunica muscularis, particularly in the corpus, should be taken into account when surgical treatment follows gastric balloon implantation. The staple suture height should be adjusted to the altered tissue composition since reduced tissue elasticity must be expected due to fibrosis.
PURPOSE: The implantation of a gastric balloon (also known as intragastric balloon) is an established and reversible endoscopic procedure for adiposity therapy. Structural changes of the stomach wall are expected to occur with gastric balloon implantation; however, until now these changes have rarely been investigated. METHODS: We compared the histological structure of the stomach wall after gastric-sleeve resection in a group of patients following gastric balloon implantation and a group without previous gastric balloon implantation. RESULTS: Following gastric balloon implantation, the tunica muscularis was found to be significantly thicker than without gastric balloon implantation. The enlarging of the tunica muscularis is not caused by hyperplasia of the leiomyocytes, but by hypertrophy of the leiomyocytes and an increase in collagen fibers (fibrosis). CONCLUSION: A longer-lasting hypertrophy of the tunica muscularis, particularly in the corpus, should be taken into account when surgical treatment follows gastric balloon implantation. The staple suture height should be adjusted to the altered tissue composition since reduced tissue elasticity must be expected due to fibrosis.
Authors: A Riphaus; T Wehrmann; J Hausmann; B Weber; S von Delius; M Jung; P Tonner; J Arnold; A Behrens; U Beilenhoff; H Bitter; D Domagk; S In der Smitten; B Kallinowski; A Meining; A Schaible; D Schilling; H Seifert; F Wappler; I Kopp Journal: Z Gastroenterol Date: 2015-08-18 Impact factor: 2.000
Authors: Carlos Zerrweck; Vincent Maunoury; Robert Caiazzo; Julien Branche; Guélareh Dezfoulian; Philippe Bulois; Helene Verkindt; Marie Pigeyre; Laurent Arnalsteen; François Pattou Journal: Obes Surg Date: 2012-05 Impact factor: 4.129