Routine Intra-gastric Balloon Insertion in the Management of 'Super-Super-Obese' Patients: an Obituary?

PURPOSE

To prospectively evaluate the feasibility of single-stage bariatric surgery in patients with super-super obesity and compare their outcomes with patients undergoing intra-gastric balloon insertion as a bridging device prior to definitive surgery.

MATERIALS AND METHODS

Data from 42 patients with BMI 60-75 kg/m who underwent either intra-gastric balloon insertion followed by sleeve gastrectomy (two-stage group); or attempted bariatric surgery as a single-stage procedure were compared.

RESULTS

All patients in the single-stage group underwent successful bariatric surgery. Length of hospital stay after definitive bariatric surgery (3.3 ± 1.9 vs 2.2 ± 0.6 days, p = 0.005) and overall complication rates were significantly higher in the two-stage group.

CONCLUSIONS

Routine use of an intra-gastric balloon in super-super obese patients is not required and may be associated with poorer peri-operative outcomes and delayed weight loss.