BS SO04 - Intragastric Balloons - are they for the long term?

Abstract Background Intragastric balloons are a bridging therapy to bariatric metabolic surgery. When sufficient weight loss to facilitate surgery is not achieved, a second balloon may be considered. Traditionally, balloons were used for 6 months prior to removal. The COVID-19 pandemic limited patient interactions and treatment duration was doubled. We assessed outcomes (weight loss trends and safety) in patients with severe obesity undergoing sequential balloon treatment. The study period accounts for changes in balloon protocol instigated during the pandemic, addressing a current literature gap. Method Consecutive patients who underwent balloon treatment between May 2014 and February 2023 were identified. Only patients deemed fit enough for potential adjuvant bariatric surgery at presentation were included in the study. Outcomes recorded included: weight and BMI at 3-monthly intervals until balloon removal, progression to surgery and morbidity. Results 45 patients were identified. Median BMI on balloon insertion was 62kg/m2. Median weight loss with the first balloon was 15.2kg (8.8% weight loss). 11 patients (24.4%) had a second balloon, with median weight loss of 3.3kg (1.9%). 22 patients (48.8%) met criteria for surgery, only one had multiple balloons. Weight loss was observed during the first three quartiles of balloon treatment, however median 2kg was gained during months 9-12. 16 (35.6%) first balloon patients had complications. 2 (18.2%) second balloon patients had complications. Median time from insertion to complication was 14 days. Conclusion The present study concludes that, although not associated with increased complication risk, sequential IGB use as a bridging treatment to definitive bariatric surgery does not significantly contribute to weight loss in super obese patients. Optimal treatment is achieved with a single IGB, although weight loss is not uniform across a 12 month treatment period and weight gain can result after 9 months.