Intragastric Balloon

Introduction

The Intragastric Balloon (the BIB® System) is a weight loss or 'bariatric' procedure which can help patients who are significantly obese*.

The major issue with obesity, from a medical perspective, is its association with a range of serious metabolic conditions, including...

  • Diabetes.
  • High blood pressure.
  • Obstructive sleep apnoea.
  • High cholesterol / high triglycerides.
  • Infertility.
  • Polycystic ovarian syndrome.

Therefore, it is highly recommended that people who are overweight or obese reduce weight to minimise their risk of developing any of these conditions (or making them worse if they already have these conditions).

The BIB® System is a non-surgical, non-pharmaceutical aid in the treatment of obesity. In conjunction with a supervised diet and behavior modification program, it can help you achieve the health and aesthetic benefits associated with weight loss.

The BIB® System consists of a soft, expandable balloon, the placement tube and a filling system so a surgeon can orally insert the weight loss aid.

Once inserted in the stomach, the empty balloon is filled with sterile saline. When full, the balloon is too large to pass into the bowel and will now float freely in the stomach.

How does the BIB® System work?

The BIB® System is designed to make compliance with a supervised diet and behavior modification program easier. The balloon partially fills the stomach and patients report that they have a feeling of fullness.

How long can the BIB® System Balloon be used?

The balloon currently can be used for six months. Longer periods of use are not recommended. Over time the acidic content of the stomach will weaken the balloon material and cause the balloon to deflate. Should your surgeon recommend use of the balloon for longer than six months, it is necessary that the balloon be replaced with a new one when the six-month interval has been met.

While you are using the balloon, your surgeon may prescribe a course of oral medication to reduce your stomach acid (this may reduce the possibility of stomach irritation and damage to the balloon).

How much weight will I lose with the BIB® System?

It is important to understand that the BIB® System is an aid to weight loss and must be used in conjunction with a prescribed diet and behavior modification program. Therefore, the amount of weight you lose will depend on how closely you follow your diet. How long you maintain weight loss will depend on how completely you adopt long-term lifestyle changes involving eating behavior and exercise.

Will I regain my weight after the BIB® System Balloon is removed?

Because the balloon in the stomach creates a feeling of fullness, it acts as an aid to weight reduction and may help you to adhere to a prescribed diet. You will have a much greater chance of maintaining your weight loss after balloon removal if you maintain and improve the diet and behavior changes you made while using the balloon.

Indications

The BIB® System is designed to assist with weight loss in people who are at least 40% above their ideal weight (as defined by the Metropolitan Life Insurance 1983 Weight and Frame tables), and who have failed to obtain prolonged weight loss with other weight control programs.

The BIB® System may be particularly useful for people considered too overweight or at increased risk for vital surgery. The use of the BIB® System to successfully reduce weight prior to surgery may help reduce the risks associated with surgical procedures on overweight patients.

Preoperative Instructions

Before the procedure you should...

  • Adopt a 'soft solid' diet for the 48 hours ahead of the procedure.
  • Not eat any solid food after 12am (midnight) on the night before the procedure.
  • Continue to take any medication you are on, with a small sip of water at least 4 hours before the procedure (thereafter nil by mouth).

Please inform Dr Watson or his team of any medications you are currently taking and they will be able to advise you how to proceed.

Procedure

The balloon is introduced into the stomach through the mouth without the need for surgery.

The surgeon conducts an initial examination of the stomach using an endoscopic camera. If no abnormalities are observed, the surgeon proceeds with placement of the balloon through the mouth and down the esophagus into the stomach.

The balloon is made of a soft and pliable silicone elastomer material and is inserted while in its smallest, deflated form. The swallowing process is made easier with the help of anesthetics applied topically to numb the throat area. Muscle relaxing medications are also used.

Once the balloon is inside the stomach, it is immediately filled with sterile saline through a small filling tube (catheter) attached to the balloon. Once filled, the doctor removes the catheter by gently pulling on the external end. The balloon has a self-sealing valve, and at this point the balloon is floating freely in the stomach.

Placement times vary but it will usually take 20-30 minutes, after which you will be monitored by the surgeon for a short time and then may return home.

Postoperative Instructions

It is important to be aware that you may still be affected by the anaesthetic for up to 24 hours after the procedure. During this period, you may experience any of the following symptoms...

  • Blurred vision.
  • Dizziness.
  • Memory loss (short-term).
  • Nausea.
  • Pain.
  • Throat soreness.
  • Vomiting.

This is normal. During this 24-hour period you should also not drive a vehicle, operate machinery, drink alcohol or make any important decisions or sign any important documents.

Removal of the BIB® System Balloon

The balloon is normally removed in the same way it was placed, via the oesophagus and mouth. Prior to removal, you will be given a muscle relaxant and a topical anaesthetic will be applied to numb the throat. Using an endoscopic camera, the surgeon will introduce a catheter through the mouth and into the stomach. The balloon will then be punctured and deflated. Once the balloon is deflated it can be grasped and removed.

Risks

Possible unpleasant effects of the BIB® System

It is very likely that the presence of the balloon in the stomach will cause nausea or vomiting for a few days after placement. Your surgeon can prescribe medication to alleviate these potential effects.

There exists the possibility that you will lose only a small amount of weight or lose no weight at all while using the balloon. Of course, as stated earlier, your commitment to dietary and behavioural changes is a pivotal factor in the outcome.

There is also the chance that unhealthy, uncontrolled weight loss will occur and create adverse health consequences. Be sure to speak with your surgeon or doctor about this.

Spontaneous deflation of the BIB® System Balloon

If the balloon deflates before a scheduled removal you may or may not be aware that it has occurred. Your surgeon may place a colored dye inside the balloon in order to help you clearly identify early deflation by a change in the color of your urine.

The balloon is small enough that it may pass through the intestines and leave the body naturally, but there have been some cases in which it has had to be removed from the bowel surgically. If you suspect a deflation, you must notify your surgeon (or doctor) immediately.

Treatment Alternatives

Read about other weight loss procedures, including:

Laparoscopic Gastric Banding

Laparoscopic Gastric Bypass

Laparoscopic Sleeve Gastrectomy

*obesity is most commonly measured as Body Mass Index (BMI) - this is the weight in kilograms divided by the height squared - for example a person weighing 120kg and 1.6m tall has a BMI of 47. Obesity is defined as a BMI reading over 30.


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