Clinical Endoscopy

FOCUSED REVIEW SERIES: Endoscopic Managements for Patients with Obesity and Its Related Comorbidities

The Clinical and Metabolic Effects of Intragastric Balloon on Morbid Obesity and Its Related Comorbidities: Joon Hyun Cho, Mohammad Bilal, Min Cheol Kim, Jonah Cohen, The Study Group for Endoscopic Bariatric and Metabolic Therapies of the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2021;54(1):9-16. Published online January 29, 2021; DOI: https://doi.org/10.5946/ce.2020.302

Obesity is becoming increasingly prevalent worldwide, and its metabolic sequelae lead to a significant burden on healthcare resources. Options for the management of obesity include lifestyle modification, pharmacological treatment, surgery, and endoscopic bariatric therapies (EBTs). Among these, EBTs are more effective than diet and lifestyle modification and are less invasive than bariatric surgery. In recent years, there have been significant advances in technologies pertaining to EBTs. Of all the available EBTs, there is a significant amount of clinical experience and published data regarding intragastric balloons (IGBs) because of their comparatively long development period. Currently, the United States Food and Drug Administration (FDA) has approved three IGBs, including Orbera (Apollo Endosurgery, Austin, TX, USA), ReShape Duo (ReShape Medical, San Clemente, CA, USA), and Obalon (Obalon Therapeutics, Carlsbad, CA, USA). The aim of this review is to summarize the available literature on the efficacy of IGBs in weight loss and their impact on obesity-related metabolic diseases.

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Kwang Gyun Lee, Seung-Joo Nam, Hyuk Soon Choi, Hang Lak Lee, Jai Hoon Yoon, Chan Hyuk Park, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Sung Hoon Jung
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Focused Review Series: Updates on endoscopic bariatric and metabolic therapies

Various Intragastric Balloons Under Clinical Investigation: Seong Ji Choi, Hyuk Soon Choi; Clin Endosc 2018;51(5):407-415. Published online September 27, 2018; DOI: https://doi.org/10.5946/ce.2018.140

Abstract PDF PubReader ePub

Obesity is a chronic disease with an exponentially increasing incidence rate, and its negative effects are well documented in numerous studies. As a result, the importance of bariatric therapy cannot be overemphasized, and many bariatric treatment methods with varying mechanisms have been developed. Of the available treatment methods, intragastric balloons, introduced in the 1980s, have been shown to be a safe and effective treatment modality; various intragastric balloon products have been developed and are currently being widely used in clinical settings. However, the disadvantages of intragastric balloons, such as unclear long-term weight loss benefits and complications experienced during insertion and removal, preclude their wider use. In this review, we discuss different intragastric balloon products, focusing on those under clinical investigation, and suggest future research directions.

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Effectiveness and Safety of the Allurion Swallowable Intragastric Balloon for Short-term Weight Loss: A Systematic Review and Meta-analysis
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A vibrating ingestible bio-electronic stimulator modulates gastric stretch receptors for illusory satiety
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Shriya S. Srinivasan, Amro Alshareef, Alexandria Hwang, Ceara Byrne, Johannes Kuosmanen, Keiko Ishida, Joshua Jenkins, Sabrina Liu, Adam Gierlach, Wiam Abdalla Mohammed Madani, Alison M. Hayward, Niora Fabian, Giovanni Traverso
Science Advances.2023;[Epub] CrossRef
Impact of Intragastric Balloon Placement on the Stomach Wall: A Prospective Cohort Study
Anna Rzepa, Michał Wysocki, Jerzy Hankus, Joanna Szpor, Jadwiga Dworak, Mateusz Wierdak, Piotr Małczak, Tomasz Stefura, Edyta Korbut, Marcin Surmiak, Marcin Magierowski, Michał Pędziwiatr, Piotr Major
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Adherence to Healthy Lifestyle Habits Is a Determinant of the Effectiveness of Weight Loss among Patients Undergoing Endoscopic Bariatric Therapies
Gemma Miranda-Peñarroya, María Fernanda Zerón-Rugerio, Marta Vallejo-Gracia, Ricardo Sorio-Fuentes, Fernando Saenger-Ruiz, Maria Izquierdo-Pulido
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The Clinical and Metabolic Effects of Intragastric Balloon on Morbid Obesity and Its Related Comorbidities
Joon Hyun Cho, Mohammad Bilal, Min Cheol Kim, Jonah Cohen
Clinical Endoscopy.2021; 54(1): 9. CrossRef
The Effect of Endoscopic Bariatric and Metabolic Therapies on Gastroesophageal Reflux Disease
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Case Reports

Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss: Larrite Reed, Hawa Edriss, Kenneth Nugent; Clin Endosc 2018;51(6):584-586. Published online June 1, 2018; DOI: https://doi.org/10.5946/ce.2018.038

Abstract PDF PubReader ePub

Obesity in the United States is a medical crisis with many people attempting to lose weight with caloric restriction. Some patients choose minimally invasive weight loss solutions, such as intragastric balloon systems. These balloon systems were approved by the Federal Drug Administration (FDA) in 2015–2016 and have been considered safe, with minimal side effects. We report a patient with a two-day history of melena, abdominal pain, hypotension, and syncope which developed five months after placement of an intragastric balloon. Esophagogastroduodenoscopy with balloon removal revealed a small 8-mm gastric ulcer in the incisura. This gastric ulcer probably developed secondary to mechanical compression of the stomach mucosa by the gastric balloon which contained 900 mL of saline. The FDA is now investigating five deaths since 2016 associated with these second-generation balloons. Clinicians should be aware of these complications when evaluating patients with gastrointestinal complications, such as bleeding.

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Gastric Perforation Secondary to a Hyperinflated Intragastric Balloon: A Case Report and Management Approach
Solomon Raj Vasudayan, Guo Hou Loo, Guhan Muthkumaran, Nik Ritza Kosai
Cureus.2025;[Epub] CrossRef
Prediction Factors of Early Postoperative Bleeding after Bariatric Surgery
Mahdieh Golzarand, Karamollah Toolabi, Reza Parsaei
Obesity Surgery.2022; 32(7): 1. CrossRef
Clinical follow-up on weight loss, glycemic control, and safety aspects of 24 months of duodenal-jejunal bypass liner implantation
B. Betzel, M. I. Cooiman, E. O. Aarts, I. M. C. Janssen, P. J. Wahab, M. J. M. Groenen, J. P. H. Drenth, F. J. Berends
Surgical Endoscopy.2020; 34(1): 209. CrossRef
Hidden dangers and updated labels on gastric balloons
Sindhura Kolli, Andrew Ofosu, Harini Gurram, Simcha Weissman, Paul Khoi Dang‐Ho, Tej I. Mehta, Hailie Gill, Krishna C. Gurram
Clinical Case Reports.2020; 8(11): 2116. CrossRef

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105 Download
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Gastric Perforation Caused by an Intragastric Balloon: Endoscopic Findings: In Kyung Yoo, Hoon Jai Chun, Yoon Tae Jeen; Clin Endosc 2017;50(6):602-604. Published online May 18, 2017; DOI: https://doi.org/10.5946/ce.2017.015

Abstract PDF Supplementary Material PubReader ePub

Intragastric balloon (IGB) insertion has been most frequently used in the West as an effective endoscopic treatment for morbid obesity, in practice. Recently, there is a growing number of cases requiring IGB deployment for obesity treatment in Korea. One of the reported complications of IGB use is gastric perforation. A 47-year-old woman was admitted to the hospital with mild symptoms, 7 weeks after having an IGB placed. Esophagogastroduodenoscopy was performed and gastric ulcer perforation was observed in the ulcer base, where food particles were impacted. Laparoscopic primary repair was done successfully. This was a case of gastric perforation, secondary to poor compliance with a proton-pump inhibitor (PPI). PPI and Helicobacter pylori eradication are important for ulcer prevention following IGB deployment.

Citations

Citations to this article as recorded by

Gastric Perforation Secondary to a Hyperinflated Intragastric Balloon: A Case Report and Management Approach
Solomon Raj Vasudayan, Guo Hou Loo, Guhan Muthkumaran, Nik Ritza Kosai
Cureus.2025;[Epub] CrossRef
Common, Less Common, and Unexpected Complications after Bariatric Surgery: A Pictorial Essay
Francesca Iacobellis, Giuseppina Dell’Aversano Orabona, Antonio Brillantino, Marco Di Serafino, Alessandro Rengo, Paola Crivelli, Luigia Romano, Mariano Scaglione
Diagnostics.2022; 12(11): 2637. CrossRef
Endoscopic bariatric therapies for obesity: a review
Dominic A Staudenmann, Zhixian Sui, Payal Saxena, Arthur J Kaffes, George Marinos, Vivek Kumbhari, Patrick Aepli, Adrian Sartoretto
Medical Journal of Australia.2021; 215(4): 183. CrossRef
Stomach Volume Assessment Using Three-dimensional Computed Tomography Gastrography for Bariatric Treatment
Seung Han Kim, Bora Keum, Hyuk Soon Choi, Eun Sun Kim, Yeon Seok Seo, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim
Obesity Surgery.2020; 30(2): 401. CrossRef
COMBINED ENDOSCOPY AND LAPAROSCOPIC APPROACH OF A GASTRIC PERFORATION DUE TO INTRAGASTRIC BALLOON INSERTION
Guillermo Perez Aguado, José Carlos Cabrera Marrero, Lucía Jiménez-Ruano
Revista Española de Enfermedades Digestivas.2020;[Epub] CrossRef
The role of silent helicobacter pylori infection in intragastric ulcers induced by balloon insertion used for management of obesity
Tamer Haydara, Ahmed M. Kabel, Ayman M. Elsaka
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2019; 13(1): 116. CrossRef
Review article: Postoperative bariatric patients in the emergency department: Review of surgical complications for the emergency physician
Ryan Windish, Jason Wong
Emergency Medicine Australasia.2019; 31(3): 309. CrossRef
Currently Available Non-Balloon Devices
Hang Lak Lee
Clinical Endoscopy.2018; 51(5): 416. CrossRef
Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss
Larrite Reed, Hawa Edriss, Kenneth Nugent
Clinical Endoscopy.2018; 51(6): 584. CrossRef
Exclusively endoscopic approach to treating gastric perforation caused by an intragastric balloon: case series and literature review
Sérgio Alexandre Barrichello Junior, Igor Braga Ribeiro, Ricardo José Fittipaldi-Fernandez, Ana Carolina Hoff, Diogo Turiani Hourneaux de Moura, Mauricio Kazuyoshi Minata, Thiago Ferreira de Souza, Manoel dos Passos Galvão Neto, Eduardo Guimarães Hourneau
Endoscopy International Open.2018; 06(11): E1322. CrossRef

7,171 View
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