Intragastric Balloon for Weight Management

Foreword
Preface
Contents
Contributors
Part I: Introductory Issues
	1: Intragastric Balloon History
		The Rapunzel Syndrome
		Minimally Invasive Philosophy: An Alternative to Surgery
		Early Development
		Europe: The Taylor Balloon and the Ballobes Bubble
		The Ideal Intragastric Balloon
		Gastric Balloons Regain FDA Approval
		South America: The Silimed Gastric Balloon (SGB)
		Adjustable Volume
		Is Endoscopy De Rigueur for IGB Placement?
		An ‘Easy-to-Swallow’ Treatment for Weight Loss
		Balloon-Like Devices: The Semistationary Antral Balloon (SAB) and the Transpyloric Shuttle (TPS)
		Experimental Devices: Balloon to Butterfly
		Comparison of IGBs
		Conclusion
		References
	2: Overview of Intragastric Balloons on an Evidence-Based Perspective
		Introduction
		Types of Balloons
		Results
			BMI Loss
			Weight Loss
			% Excess Weight Loss (EWL)
			Safety
			Comorbidities
		Final Considerations
		References
	3: Indications and Uses of the Intragastric Balloon
		Introduction
		Indications and Contraindications for Gastric Balloon Insertion
			Contraindications of Intragastric Balloon
		Uses and Application of Intragastric Balloon in Obese Patients
			Body Weight Loss
			Improvement in Obesity-Related Comorbidities and Metabolic Diseases
			Alteration in Gastrointestinal Hormones
		Conclusion
		References
	4: Brazilian Experience on the Use of Intragastric Balloons
		Introduction
		Brazilian Experience Data
		Consensus Results
			Indications and Contraindications
				Placement
				Absolute Contraindications
				Relative Contraindications
			Pre-procedure Evaluation and Multidisciplinary Follow-Up
				Prior Endoscopy and Exams
			Technique
				Balloon Implant
				Anesthesia
				Balloon Volume
				Balloon Explant
				Anesthesia
				Technique
			Post-implant Follow-Up
			Adverse Events
		Conclusions
		References
	5: How the Intragastric Balloon Fits in a Service of Bariatric Endoscopy: Brazilian Perspective
		Introduction
		Brazilian Perspective
		Indications for Balloon in a Bariatric Endoscopy Service
			BMI Between 25 and 35 Kg/m2
			BMI Between 35 and 40 Kg/m2
			Super-Obese with a BMI 50 or Higher, to Reduce Surgical Risk Before Bariatric Surgery
			BMI 40 or Higher, Who Do Not Want or Cannot Undergo Bariatric Surgery
		Final Considerations
		References
	6: Bariatric Surgeon Perspective on Bariatric Endoscopy and Intragastric Balloons: European Perspective
		Introduction
		Clinical and Diagnostic Aspects of the Disease
			Role of Endoscopy in the Field of Bariatric and Metabolic Surgery
			The Intragastric Balloon as a Weight Loss Procedure
				Era of Open Bariatric Surgery and First Balloon Trials: Before 1990
				First Trials and Congress Presentations: 1990–2000
					Studies in the Netherlands
					Studies in the UK
					Studies in Italy
					Studies in Germany
				Period After the Year 2000
			Diabetes Type 2 and Metabolic Syndrome
		Indications and Contraindications of the Procedure
			Intragastric Balloon
				Indications
				Contraindications
			Aspire
				Indications
				Contraindications
			Overstitch (Treatment of the Gastrojejunostomy)
				Indications
				Contraindications
			Endosleeve (Endoscopic Sleeve Gastroplasty)
				Indications
			Endobarrier
				Indications
				Contraindications
			Duodenal Ablation
				Indications
		Endoscopic Maneuvers in the Management of Complications After Bariatric Surgery
		Discussion
		Conclusion
		References
	7: Use of Intragastric Balloons in the Middle East: A Bariatric Surgeon Survey
		Introduction
		Results
		Discussion
		Different Types of IGB on the Market and Their Use in the Middle East According to Our Survey
			Orbera (BioEnterics)
			Ellipse
			Heliosphere Bag
			Medsil
			Obalon
			Spatz
			ReShape Duo
			Transpyloric Shuttle
			SatiSphere
			Adjustable Totally Implantable Intragastric Prosthesis (ATIIP)
		Conclusions
		References
Part II: Devices
	8: Liquid-Filled Balloon
		Introduction
		History and Outcomes of ORBERA
		The Device
		Indications
		Contraindications
		Procedure and Patient Management
		Aftercare Platform
		References
	9: Adjustable Liquid-Filled Balloon: An Overview
		Introduction
		Differences of the Spatz® Adjustable Balloon
		Results
		Complications
		Conclusion
		References
	10: Liquid-Filled Double Balloon: U.S. Experience
		Introduction
		Placement and Removal Techniques
		Patient Management
		US Outcomes
			US Food and Drug Administration (FDA) Clinical Study
			Clinical US Experience After FDA Approval
		Conclusion
		References
	11: Mexican Experience in the Treatment of Obesity with Liquid-Filled Balloon
		Introduction
		Indications
		Nutritional Evaluation
		Psychological Evaluation
		Results
		Conclusions
		References
	12: Obalon Intragastric Balloon System Overview
		History
		Introduction
		Obalon Balloon Inflation System Overview
		Placement
		Medications Post Placement
		Indications for Use
		Contraindications
		Adverse Reactions
		Conclusions
		References
	13: The US Experience with Swallowable Gas-Filled Balloons
		References
	14: First Human Studies on Swallowable, Gas-Filled Balloon: The Obalon Balloon
		Introduction
		Clinical Experience
		Discussion
		Final Considerations
		References
Part III: Technical Procedures and Related Issues
	15: Material: What Is the Minimum, the Desirable, and the Optimal
		Introduction
		Intragastric Balloon Insertion
		Intragastric Balloon Removal
		Conclusions
		References
	16: Liquid-Filled Intragastric Balloon: Implant and Removal Techniques
		Introduction
		Implant Technique
			Pre-procedure
			Procedure
			After Procedure
		Removal Technique
			Before the Procedure
			Procedure
			After Procedure
		Conclusions
		References
	17: Adjustable Intragastric Balloon – Implantation and Removal
		Introduction
		Implantation of the Spatz® Balloon
		Balloon Adjustment Procedure
		Removal of the Balloon
		Conclusion
		References
	18: Air-Filled Intragastric Balloon Implant
		Introduction
		Indications and Contraindications
		Air-Filled Balloon Placement
			Technique
		Air-Filled Balloon Removal
			Technique
		Discussion
		Final Considerations
		References
Part IV: Acute Complications and Treatment
	19: Intolerance to the Device – Abdominal Pain, Nausea, and Others
		Introduction
		Clinical Presentation
		Symptoms and Balloon Types
		Treatment and Prevention
		Other Device-Related Complications
			Pancreatitis
			Gastric Outlet Obstruction
		Conclusions
		References
	20: Impaction of Intragastric Balloon in the Antrum
		Introduction
		Clinical Case
		Endoscopic Procedure to Remove the Intragastric Balloon
			Follow-Up
		Discussion
		Final Considerations
		References
	21: Intestinal Migration of an Air-Filled Balloon: Laparoscopic Removal
		Introduction
		Clinical Case
		Discussion
		Conclusions
		References
	22: Migration of the Liquid-Filled Balloon: Intestinal Sub-occlusion
		Introduction
		Clinical Case
		Discussion
		Final Remarks
		References
	23: Gastric Perforation by Intragastric Balloon
		Introduction
		Clinical Case
		Discussion
		Final Remarks
		References
	24: Hyperinflated Intragastric Balloon
		Introduction
		Epidemiology/Causes
			Iatrogenic
			Fungal Contamination
		Pathophysiology
		Case Report
		Treatment
		Conclusion
		References
	25: Problems in the Implantation of the Intragastric Balloon
		Introduction
		Clinical Case 1
			Endoscopic Procedure
		Clinical Case 2
			Endoscopic Procedure
		Clinical Case 3
			Endoscopic Procedure
		Discussion
		Final Considerations
		References
Part V: Chronic Complications and Treatment
	26: Helicobacter pylori and Intragastric Balloons
		Introduction
		Helicobacter Pylori and Obesity
		Diagnosis
		Treatment
		References
	27: Fungal Colonization
		Introduction
		Clinical and Diagnostic Aspects of the Disease
		Case Reports
		Discussion
		References
Part VI: Special Populations
	28: Intragastric Balloons in Pediatric Patients and Special Populations
		Introduction
		Discussion
			Intragastric Balloons in Pediatric Patients
			Special Populations – The Elderly, Chronic Diseases, and Situs Inversus
		Final Considerations
		References
	29: Intragastric Balloons as a Bridge to Bariatric and Non-bariatric Surgery in Super-Obese Patients
		Introduction
		Discussion
		Final Considerations
		References
Part VII: Miscellaneous
	30: Drug Regimen and Intragastric Balloon: Pre, Post, During, Combined
		Introduction
		Medications for IGB Symptoms Relief
			Drugs Before Balloon Placement
			Drugs Used During IGB Placement
			Drugs Used After IGB Placement
		Antiobesity Drugs During IGB Treatment
		Discussion
			Clinical Treatment of Obesity
			Weight Regain After Intragastric Balloon Removal
		Final Considerations
		References
	31: Nutritional Follow-Up During Intragastric Balloon Treatment
		Introduction
		Diet Progression
		Adjustable Intragastric Balloon
			Volumetric Reduction of the Adjustable IGB Due to Patient Discomfort
			Intolerance and Food Impaction
			Protein Content of the Diet
		Diet for IGB Removal
		Follow-Up After Removal
		References
	32: Psychotherapy in Intragastric Balloon Treatment
		Introduction
		Psychotherapeutic Approaches to Obesity
			Self-Monitoring
			Goal Setting
			Stimulus Control
			Problem-Solving
			Relapse Prevention
			Cognitive Restructuring
		Interpersonal Psychotherapy for Obesity
		Mindfulness
		Psychodynamic Psychotherapy
		Final Considerations
		References
	33: Physical Activities
		Introduction
		Physical Activity and the Bariatric Patient
		The Benefits of Physical Activity
		Obesity Treatment
		Conclusion
		References
Index