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CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(02): E122-E129
DOI: 10.1055/a-0809-4994
Review
Owner and Copyright © Georg Thieme Verlag KG 2019

Life-threatening visceral complications after intragastric balloon insertion: Is the device, the patient or the doctor to blame?

George Stavrou
1   Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
2   Department of General Surgery, York Teaching Hospital, NHS Foundation Trust, York, UK
,
Georgia Tsaousi
1   Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Katerina Kotzampassi
1   Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
› Author Affiliations
Further Information

Publication History

submitted 24 July 2018

accepted after revision 26 October 2018

Publication Date:
22 January 2019 (online)

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Abstract

Background and aim Intragastric balloon placement is established as a safe, relatively low-cost and well-tolerated minimally invasive procedure for weight loss, giving encouraging results under the strict prerequisite that the obese patient will enroll in a medically supervised weight loss program. This retrospective study reviews already published cases of severe visceral complications for the purpose of assigning responsibility to the device, the patient, or the doctor.

Methods We reviewed PubMed and Scopus archived publications describing intragastric balloon (BIB/Orbera)-related severe visceral complications, i. e. perforations and obstructions.

Results Twenty-two cases of gastric perforation, two cases of esophageal perforation and 10 cases of bowel obstruction were found. For the gastric perforation the endoscopist was responsible in nine cases, the patient in four, and the balloon itself in nine. For the two cases of esophageal perforation, the endoscopists were responsible, while for the 12 cases of bowel obstruction, the patient was responsible for seven and the device for the other five cases.

Conclusion BIB/Orbera balloon insertion remains a safe procedure, with a minimum of complications related to hollow viscera. Mandatory education and accreditation of physicians dealing with bariatric endoscopy and strict supervision of the obese individuals, while living with the balloon, will eliminate such complications.

 

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