Gastric balloon surgery is a minimal non-invasive weight loss surgery. It was first performed in the USA and was approved by the US Food and Drug Administration(FDA). The whole procedure takes about 20 minutes under sedation and it is performed by a qualified gastroenterologist. The procedure involves inserting a soft balloon into the patient’s stomach through the mouth using an endoscope. The balloon is inserted in a deflated state and it is later inflated by filling it with a saline solution. It fills your stomach leaving less room for large amounts of food and drink intake. With the gastric balloon in place, one tends to feel full after and between meals. It allows you to get used to having smaller food portions and adopting a healthier lifestyle. As you eat a smaller amount of food, you lose weight. It won’t help if you eat soft foods, and sweets or drink high-calorie liquids. You must be committed to a supervised gastric balloon diet and modified lifestyle both whilst the balloon is inserted and after it has been removed.

The gastric balloon which is temporarily inserted in a patient’s stomach is supposed to be removed after six months. During removal, the gastric balloon is deflated and then pulled through the mouth using an endoscopic tube. Once it is removed the stomach returns to its normal size and shape. When the gastric balloon is removed you will, hopefully, continue with your newly trained lifestyle and eating patterns. This type of surgery should be accompanied by a balanced diet and physical activity for one to lose weight to the desired size.

According to previous research and monitoring of patients who have undergone the surgery, it has been noted that patients who underwent the surgery lost more weight in a short period compared to those who relied on diet and exercise for weight loss. However, some patients had a hard time adjusting to the balloon while others adjusted to it a lot easier. Those who had a hard time adjusting reported symptoms such as nausea and bloating during the first few days, but after a while, the symptoms cleared up. Patients are usually advised to avoid unnecessary physical activities during the first few weeks. After adjusting to the balloon, the patient can now increase their activity levels and create an exercise routine. Regular sessions with the gastroenterologist are a requirement to keep track of the progress and discuss a sensible meal plan.

Who is it recommended to

This type of surgery is recommended for individuals who:

• Are required to lose weight before an operation to reduce surgical risks.
• Want a non-surgical treatment option for weight loss
• Want to lose weight without having to go through intense exercises
• Are not extremely obese
• Are not able to undergo bariatric surgery.

While considering whether or not to have a gastric balloon it is important to consult with your gastroenterologist. Have them take you through the risks and complications that are likely to occur during the surgery and you might want to see before and after photographs of patients who have undergone the treatment before. The success of the treatment is dependent on whether the recipient can carry on the same habits after the balloon is removed.

Pros and Cons

As everything has its advantage and disadvantages so do gastric balloon surgery. Let us look at some
of the pros and cons of this type of surgery:

Pros

1. Since the surgery does not involve the breaking of the skin as it is non-invasive it is considered
   safe.
2. It is a very quick procedure that takes a short recovery period. One can easily resume their daily
   activities without difficulty.
3. It does involve the intake of a daily nutritional supplement.
4. This type of surgery has been known to improve obesity-related conditions such as high blood pressure and stroke among others.
5. The effects are reversible.

Cons

1. A patient might develop gastric problems such as reflux, abdominal pain, nausea, cramps,
   bloating, and vomiting.
2. On rare occasions, one can develop ulcers.
3. There are chances of leakage or bursting of the balloon.
4. In a case where there was a fault while inserting the balloon, rupture or bleeding in the stomach
   or windpipe is likely to occur.

Surgical Risk

Gastric balloon surgery procedures are generally safe and effective but can be associated with devastating complications, some of which may be fatal if not addressed quickly, thus acute care surgeons need to have familiarized with some of these problems and their management. Some of these risks include;

1. Leaks – This is the most feared complication which further prolongs hospital stay and can further result in gastroenteric and gastrobronchial fistulae which can take more months to resolve. It takes roughly 3 days after surgery for the symptoms of a leak to present and most of the time, most patients would have already been discharged and thus, need to be taken to the emergency room immediately. It’s worth noting that it mostly presents in patients with a body mass index (BMI) of >50 kg/m²
2. Stenosis, twists, or kinks – Some patients report a stuck food sensation with an urge to regurgitate due to loss of luminal calibre from stenosis. It’s worth noting that it is easy to diagnose and treat without a need for a surgical operation. It can result in protein-calorie malnutrition and nutrient deficiencies which a clinician must address when caring for patients with stenosis, regardless of the cause.
3. Adjustable gastric band complications– This occurs when one wall of the stomach slips through the band, resulting in a larger-than-normal gastric pouch superior to the band, which may lead to some complications such as gastric perforation, upper gastrointestinal bleeding, and aspiration pneumonia.
4. Small bowel obstruction– it is worth noting that some patients have reported developing bowel obstructions with symptoms like diffuse abdominal pain, distension, bloating, nausea, and vomiting. In patients who have had a prior laparoscopic gastric bypass, over 50% of small bowel obstructions are caused by internal hernias. A neglected hernia can grow and be more painful which can lead to emergency surgery and more complications. Note that early repair is less risky and more successful with better outcomes and the best recovery.

Precautions before and after the surgery

Before the surgery, you must fast from food and drinks for 12 hours and before the gastric balloon is removed, you must start on a fluid-only diet 48 hours beforehand. This means no solid food at all.

Cost

Gastric balloon surgery costs Sh350,000 in Kenya while in Europe it costs about Sh600,000- Sh700,000.
The cost might differ with the hospital. Some of the hospitals that offer this treatment are Agha Khan
University Hospital and M.P. Shah Hospital in Nairobi Kenya among other hospitals.

Here is a video of the procedure.

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