IMO - Instituto Mineiro de Obesidade, Belo Horizonte, MG, Brazil.
Harvard Medical School, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA.
Obes Surg. 2019 Apr;29(4):1445-1446. doi: 10.1007/s11695-019-03771-1.
The use of intragastric balloons (IGB) for the treatment of obesity has been increasing significantly, with data confirming its effectiveness with low complication rates. Adjustable balloons are not widely available for use in all countries, including the USA. In this video, we demonstrate a unique technique in which a conventional nonadjustable balloon is modified to an adjustable balloon to improve weight loss.
A 35-year-old woman with a BMI of 36.1 kg/m (84.4 kg) who had failed prior medical therapy for obesity presented for IGB placement. After discussion with the patient, including risks and benefits, a conventional IGB modified to a novel adjustable IGB was placed.
In this primary experience, we describe the use of a conventional IGB modified to an adjustable balloon. First, during balloon placement, an initial 500 ml of saline was instilled. At one-month follow-up, the patient only experienced 3.67%TBWL; thus, the balloon was adjusted with the addition of 160 ml of saline through the newly created modification catheter. At a 2-month follow-up, a second adjustment was performed with the addition of 180 ml, for a total of 840 ml. At 4 months, patient experienced 10% TBWL and decreased in BMI by 3.6 kg/m. No adverse events were reported.
The transformation of a nonadjustable balloon into an adjustable balloon is feasible and effective in weight loss. This technique may be an alternative in cases where adjustable balloon is not available. Further studies are warranted to confirm the safety and efficacy of this novel device.
胃内球囊（IGB）在肥胖治疗中的应用显著增加，数据证实其有效性且并发症发生率低。可调节球囊在包括美国在内的许多国家尚未广泛应用。在本视频中，我们展示了一种独特的技术，即将常规不可调节球囊改装成可调节球囊，以提高减重效果。
一位 35 岁女性，BMI 为 36.1kg/m²（84.4kg），肥胖经前期药物治疗失败，前来就诊行 IGB 放置。与患者讨论后，包括风险和益处，我们选择使用常规 IGB 改装成新型可调节 IGB。
在本次初步经验中，我们描述了一种将常规 IGB 改装成可调节球囊的方法。首先，在球囊放置过程中，初始注入 500ml 生理盐水。在一个月的随访中，患者仅经历了 3.67%的 TBWL；因此，通过新创建的改装导管向球囊中添加 160ml 生理盐水进行第一次调整。在两个月的随访中，再次添加 180ml 盐水进行第二次调整，总容量达到 840ml。在四个月时，患者经历了 10%的 TBWL，BMI 下降了 3.6kg/m²。未报告不良事件。
将不可调节球囊改装成可调节球囊是可行且有效的减肥方法。在无法使用可调节球囊的情况下，这种技术可能是一种替代方法。需要进一步的研究来证实这种新型装置的安全性和有效性。
