Intragastric Balloon as a Bridge to Bariatric Surgery: A Decade-Long Review of Weight Loss, Anesthetic Risk Reduction, and Predictive Success Factors

Aims Bariatric surgery (BS) is a safe and effective treatment for obesity, although it can be challenging due to anatomical and anesthetic issues, especially in super-obese patients (BMI≥50 kg/m²). The intragastric balloon (IGB) can be used as a bridge before definitive surgery to increase preoperative weight loss and reduce perioperative morbidity and mortality. We aim to evaluate the effectiveness of IGB in weight loss and the reduction of pre-anesthetic risk using the ASA classification (r-ASA). To identify factors associated with therapeutic success and complications of the technique.

Methods A retrospective analysis of the clinical records of patients who had an IGB placed as a bridge to bariatric surgery (BS) at our hospital center between 2012-2022 was conducted. Pre-IGB and pre-BS data were analyzed. Statistical analysis was performed using SPSS v29.0. A p-value<0.05 was considered significant.

Results Seventy-one patients who had an IGB placed were analyzed. We included 40 patients who progressed to BS, with a mean age of 47.2±11.7 years, 72.5% (n=29) of whom were female. The mean BMI was 55.2±6.2 kg/m². The average duration of IGB treatment was 7.4±2.1 months. Following IGB treatment, the mean total weight loss (TWL) was 19.7±15.4 kg, and the mean percentage of excess weight loss (%EWL) was 21.3±15.41%. The mean reduction in BMI (rBMI) was 7.2±15.4 kg/m². IGB treatment resulted in a statistically significant reduction in anesthetic risk (r-ASA) in 20% of patients (n=8; z=-2.8; p=0.005), particularly in younger patients (35.8 vs. 50.1 years; p=0.001). Younger age and the absence of pre-IGB osteoarticular pathology were independent predictive factors for reduced anesthetic risk (OR 0.868; p=0.06; OR 0.052; p=0.038, respectively). IGB treatment was discontinued in 7.5% of patients (n=3) due to prolonged nausea/food intolerance (n=2) and balloon rupture (n=1).

Conclusions In our sample, the use of IGB proved to be a safe and useful adjunct for reducing preoperative risk in BS, especially in younger patients.

Publication History

Article published online:
27 March 2025