© FD-Communications Inc. Obesity Surgery, 15, 2005 1161
Obesity Surgery, 15, 1161-1164
Background: The temporary use of the BioEnterics
Intragastric Balloon (BIB) in morbidly obesity is increas-
ing worldwide. The aim of this study is the evaluation of
the efficacy of this device in a large population, in terms
of weight loss and its influence on co-morbidities.
Methods: Data were retrospectively recruited from
the data-base of the Italian Collaborative Study Group
for Lap-Band and BIB (GILB). After diagnostic
endoscopy, the BIB was positioned and was filled
with saline (500-700 ml) and methylene blue (10 ml).
Patients were discharged with diet counselling (~1000
Kcal) and medical therapy.The BIB was removed after
6 months. Positioning and removal were performed
under conscious or unconscious sedation. Mortality,
complications, BMI, %EWL, BMI loss and co-morbidi-
ties were evaluated.
Results: From May 2000 to September 2004, 2,515
patients underwent BIB (722M/1,793F; mean age
38.9±14.7, range 12-71; mean BMI 44.4±7.8 kg/m
2
;
range 28.0-79.1; and mean excess weight 59.5±29.8
kg, range 16-210). BIB positioning was uncomplicated
in all but two cases (0.08%) with acute gastric dilation
treated conservatively. Overall complication rate was
70/2,515 (2.8%). Gastric perforation occurred in 5
patients (0.19%), 4 of whom had undergone previous
gastric surgery: 2 died and 2 were successfully
treated by laparoscopic repair after balloon removal.
19 gastric obstructions (0.76%) presented in the first
week after positioning and were successfully treated
by balloon removal. Balloon rupture (n=9; 0.36%) was
not prevalent within any particular period of BIB treat-
ment, and was also treated by BIB removal.
Esophagitis (n=32; 1.27%) and gastric ulcer (n=5;
0.2%) presented in patients without a history of pep-
tic disease and were treated conservatively by drugs.
Preoperative co-morbidities were diagnosed in
1,394/2,471 patients (56.4%); these resolved in
617/1,394 (44.3%), improved (less pharmacological
dosage or shift to other therapies) in 625/1,394
(44.8%), and were unchanged in 152/1,394 (10.9%).
After 6 months, mean BMI was 35.4±11.8 kg/m
2
(range
24-73) and %EWL was 33.9±18.7 (range 0-87). BMI
loss was 4.9±12.7 kg/m
2
(range 0-25).
Conclusions: BIB is an effective procedure with sat-
isfactory weight loss and improvement in co-morbidi-
ties after 6 months. Previous gastric surgery is a con-
traindication to BIB placement.
Key words: Obesity, intragastric balloon, weight loss, com-
plications, co-morbidity
Introduction
The BioEnterics Intragastric Balloon (BIB) is an
endoscopic device for temporary treatment of obe-
sity.
1,2
Intragastric balloon positioning is potentially
attractive to health-care practitioners who have
experienced poor results with dietary programs,
medications and behavioral therapy. Moreover, it
has been recommended as a weight reduction adju-
vant before bariatric surgery and before all kinds of
planned surgery in the morbidly obese, to reduce
life-threatening co-morbidities and lessen surgical
risk.
2-4
The aim of this study is the retrospective
evaluation in a large population of the efficacy of
the BIB in terms of weight loss and its influence on
co-morbidities.
BioEnterics Intragastric Balloon: The Italian
Experience with 2,515 Patients
A. Genco; T. Bruni; S. B. Doldi; P. Forestieri; M. Marino; L. Busetto;
C. Giardiello; L. Angrisani; L. Pecchioli; P. Stornelli; F. Puglisi;
M. Alkilani; A. Nigri; N. Di Lorenzo; F. Furbetta; A. Cascardo; M. Cipriano;
M. Lorenzo; N. Basso
Italian Group for Lap-Band
®
, Fondazione IDIS - Città della Scienza, Naples, Italy
Reprint requests to: Michele Lorenzo MD, PhD, Italian Group for
Lap-Band
®
– GILB, c/o Fondazione IDIS, Città della Scienza, via
Coroglio 156, 80124 Naples, Italy. Fax: + 39 081 2301044;
e-mail: info@iglb.it
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