THIS QUARTERLY MAGZINE – OCT 2015 ISSUE

THIS QUARTERLY MAGZINE – OCT 2015 ISSUE

GENERAL SURGERY
Beating Obesity with a balloon
An adjustable balloon in the stomach may help achieve weight loss, preventing associated illnesses like heart disease, cancer and diabetes.

Dr Ganesh Ramalingam
General Surgeon

Saline-filled balloons implanted in the stomach can help create a feeling of fullness and reduce the stomach’s capacity. The presence of the balloon also causes food to stay longer in the stomach, increasing the feeling of satiety. Coupled with dieting and healthy lifestyle habits, these intragastric balloons promise weight loss. But despite being having been around for over 17 years, though, they haven’t caught on.

This is mainly because once implanted, the balloon volume is not adjustable and starts deflating after three months. Also, the balloon must be removed after six months.

Solution: an adjustable balloon
Regular balloons are implanted at the maximum volume for better results but can feel very uncomfortable. The volume of the Spatz Adjustable Balloon System ( ABS ) can be increased or decreasedthrough an inflation port after it is inserted, so a patient can start off with a balloon of smaller volume that feels more comfortable and the doctor can increase it over time. Spatz is approved for implantation for one year. Increased weight loss is possible as there is a longer period to get used to a new diet and lifestyle.

The feeling of fullness and reduced stomach capacity is only part of the programme. The patient will meet with the doctor and a dietitian/behavior modification specialist monthly over the one year period to help change his eating behavior modification specialist monthly over the one year period to help change his eating behavior and lifestyle.

When a patient feels the balloon’s effects diminishing as their appetite resumes – usually after three months – they can have its volume increased.

How is it done?
A standard endoscopy with sedation is performed. Under sedation, the balloon is inserted through the mouth into the stomach. Once inside the stomach, the balloon is filled with sterile saline through a small filling tube attached to the balloon. The insertion takes about 10 minutes. Patients are then monitored for one hour before they go home.

Who would benefit?
The intragastric balloon is designed specifically for people who have 10 kg or more of weight to lose, or have a Body Mass Index of over 27, or are not suited for weight loss surgery. Using the balloon may help with weight loss before another surgical procedure, thus reducing operative risk.

Risk and side effects?
It is very likely that the presence of the balloon in the stomach will cause nausea, vomiting or abdominal pain of varying intensity for up to a week after insertion. Medication will minimise these potential side effects.

There is also the possibility that a patient may lose no weight or only a small amount of weight. But it’s important to remeber that the intragstric balloon is a tool that mus be used in conjunction with changes in diet and lifestyle for successful weight loss.

Any medications not permitted with the balloon?
Aspirin and other anti-inflammatory medications such as Ibuprofen are not permitted, even in small quantities or occasionally.

How will it be removed?
The spatz balloon will be removed in the same way it was inserted, through the oesophagus and mouth using endoscopy under sedation. The procedure takes less than 15 minutes with an hour of recovery time.

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