Adjustable Intragastric Balloon Research Articles

Endoscopic bariatric surgery for adults with overweight and obesity: a systematic review and network meta-analysis.

Endoscopic bariatric surgery (EBS) is a new treatment for obesity. We compared the efficacy, safety, and probability of metabolic complications of different EBSs with laparoscopic sleeve gastrectomy (LSG). This systematic review and network meta-analysis (NMA) included searches of PubMed, Web of Science, and the Cochrane Library from January 1, 2017, to December 27, 2022, to find comparative trials of EBS procedures and EBS with LSG. We performed a frequentist model NMA to summarize the evidence and ranked the interventions according to SUCRA scores. The search for this NMA yielded 14,160 articles, of which 18 eligible trials recruited 766,135 participants for procedures including LSG, endoscopic sleeve gastroplasty (ESG), nonadjustable intragastric balloon (NIB), BioEnterics Intragastric Balloon (BIB), and adjustable intragastric balloon (AIB). Definitive evidence suggests that LSG is most effective for weight reduction. Compared with LSG, NIB, SMD = -0.49 [95% CI -0.79, -0.18]; AIB, SMD = -0.41 [95% CI -0.76, -0.06] and ESG, SMD = -0.31 [95% CI -0.33, -0.29] in the index of percentage total weight loss under six months. In terms of safety outcomes, ESG had the lowest incidence of adverse events; the order of the observed incidence of adverse events from small to large was ESG, NIB, AIB, LSG, and BIB. ESG is an effective and safe minimally invasive surgical method for people with overweight and obesity. Its 12-month effect is better than that of NIB, and its influence on lipid metabolism makes it more protective of the cardiovascular system and liver. CRD42022375343.

Adjustable Intragastric Balloon Leads to Significant Improvement in Obesity-Related Lipidome and Fecal Microbiome Profiles: A Proof-of-Concept Study.

Intragastric balloons (IGBs) are a safe and effective treatment for obesity. However, limited knowledge exists on the underlying biological changes with IGB placement. This single-institution study was part of an adjustable IGB randomized controlled trial. Subjects with obesity were randomized in a 2 is to 1 ratio to 32 weeks of IGB with diet/exercise counseling (n = 8) vs counseling alone (controls, n = 4). Diet/exercise counseling was continued for 24 weeks post-IGB removal to assess weight maintenance. We used mass spectrometry for nontargeted plasma lipidomics analysis and 16S rRNA sequencing to profile the fecal microbiome. Subjects with IGBs lost 15.5% of their body weight at 32 weeks vs 2.59% for controls (P < 0.05). Maintenance of a 10.5% weight loss occurred post-IGB explant. IGB placement, followed by weight maintenance, led to a -378.9 μM/L reduction in serum free fatty acids compared with pre-IGB (95% confidence interval: 612.9, -145.0). This reduction was mainly in saturated, mono, and omega-6 fatty acids when compared with pre-IGB. Polyunsaturated phosphatidylcholines also increased after IGB placement (difference of 27 μM/L; 95% confidence interval: 1.1, 52.8). Compared with controls, saturated and omega-6 free fatty acids (linoleic and arachidonic acids) were reduced after IGB placement. The fecal microbiota changed post-IGB placement and weight maintenance vs pre-IGB (P < 0.05). Further analysis showed a possible trend toward reduced Firmicutes and increased Bacteroidetes post-IGB and counseling, a change that was not conclusively different from counseling alone. IGB treatment is associated with an altered fecal microbiome profile and may have a better effect on obesity-related lipidome than counseling alone.

Endoscopic Treatment of Obesity Using an Adjustable Intragastric Balloon

Endoscopic Treatment of Obesity Using an Adjustable Intragastric Balloon

Vücut Kitle İndeksi değerlerine göre ayarlanabilir intragastrik balon kullanım sonuçları

Aim: In our study, it was aimed to compare the results of adjustable intragastric balloons in patients according to body mass index.&#x0D; Material and Method: We recorded the data of 82 patients that we performed AIGB procedure in the last four years. During the initial implantation of the balloon, inflating was performed with 300-350 cc saline and methylene blue. Body mass index values and excess weight loss ratios of the patients at the time of the balloon removal were noted. Patients' complaints and complications arising after balloon application or additional inflation were reported.&#x0D; Results: It was determined that there was a statistically significant decrease between weight, BMI, and EWL values measured at the 4th, 8th, and 12th months after the first application was performed (p

Anatomy-preserving adjustable intragastric balloon is safe and promotes durable weight loss.

Anatomy-preserving adjustable intragastric balloon is safe and promotes durable weight loss.

Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial

Intragastric balloons are anatomy-preserving, minimally invasive obesity therapies. Enhanced tolerance and durability could help broaden clinical adoption. We investigated the safety and efficacy of an adjustable intragastric balloon (aIGB) in adults with obesity. In this prospective, multicentre, open-label, randomised clinical trial done at seven US sites, adults aged 22-65 years with obesity were randomly assigned (2:1) to aIGB with lifestyle intervention or lifestyle intervention alone (control) for 32 weeks. Balloon volume could be increased to facilitate weight loss or decreased for tolerability. Coprimary endpoints included mean percentage total bodyweight loss and responder rate (≥5% total bodyweight loss) at 32 weeks. We used a multiple imputed intention-to-treat population analysis. This study was registered with ClinicalTrials.gov, NCT02812160. Between Aug 9, 2016, and Dec 7, 2018, we randomly assigned 288 patients to aIGB (n=187 [65%]) or control (n=101 [35%]) groups. Mean total bodyweight loss at 32 weeks was 15·0% (95% CI 13·9-16·1) in the aIGB group versus 3·3% (2·0-4·6) in the control group (p<0·0001). Clinical response was observed in 171 (92%) patients in the aIGB group. Adjustments to the aIGB occurred in 145 (80%) patients for weight loss plateau or intolerance. Upward volume adjustment facilitated an additional mean 5·2% (4·5-5·8) total bodyweight loss. Downward volume adjustment allowed 21 (75%) patients in the aIGB group to complete the full duration of therapy. Intolerance caused early removal of the device in 31 (17%) patients. No micronutrient deficiencies were observed in the aIGB cohort. Device-related serious adverse events were observed in seven (4%) patients, without any deaths. When aIGB was combined with lifestyle modification, significant weight loss was achieved and maintained for 6 months following removal. Balloon volume adjustability permitted individualised therapy, maximising weight loss and tolerance. Spatz Medical.

The Adjustable Intragastric Balloon for Treatment of Obesity: Results of a Multicenter, Randomized Controlled Trial

Background: Intragastric balloons are anatomy preserving, minimally invasive therapies for obesity. Enhanced tolerance and durability inform clinical adoption. We investigated the safety and efficacy of an adjustable intragastric balloon (aIGB) with prolonged dwelling time in adults with obesity.Methods: Patients were randomized to the Spatz3 (Spatz FGIA, Great Neck, NY) aIGB with lifestyle intervention versus lifestyle intervention alone (control) for 32 weeks. The aIGB volume could be increased to facilitate weight loss or decreased for tolerability. Co-primary endpoints included mean total body weight loss (TBL) and responder rate (≥ 5% TBL) at 32 weeks. Weight loss maintenance (WLM) was reported at 14 months. Improvement in obesity-related comorbidities was reported at 32 weeks. Data were analyzed in a multiple imputed intention to treat (miITT) population. Adverse events were recorded throughout the study duration.Findings: 288 adults with obesity were randomized to aIGB (n = 187) or control (n = 101) arms. Mean TBL was 15‧0% [95% CI 13‧9%, 16‧1%] in the aIGB group vs 3‧3% [95% CI 2‧0%,4‧6%] in controls (p Interpretation: The adjustable intragastric balloon induced significant weight loss that was maintained in most patients. Adjustability of volume significantly improved safety and tolerance highlighting advantages of this therapy for clinical practice.Trial Registration: This study was registered with clinicaltrial.gov -NCT02812160.Funding: SPATZ MedicalDeclaration of Interest: BKA reports consultant roles with Endogenex, Endo-TAGSS, Metamodix, and BFKW; consultant and grant/research support from USGI, Cairn Diagnostics, Aspire Bariatrics, Boston Scientific; Speaker roles with Olympus, Johnson and Johnson; speaker and grant/research support from Medtronic, Endogastric solutions; and research support from Apollo Endosurgery, and Spatz Medical. CGC reports consultant roles with Olympus; consultant roles and payment or honoraria Apollo Endosurgery, Boston Scientific; payment or honoraria from Abbive; participation in a Data Safety Monitoring Board and consultant roles with ERBE, BFKW Inc, and Nitinotes Surgical. VP reports consultancy fees from Obalon Therapeutics Inc. PJ reports grants from Boston Scientific; licenses to Endosim; consulting fees from Endogastric solutions, ERBE; support for meetings from USGI medical; consulting fees and research support from GI dynamics; research support from Apollo Endosurgery, and Fractyl. AA reports grants from NIH-NIDDK, American Neurogastroenterology and Motility Society, Mayo Clinic Center for Individualized Medicine; Stockholder of Gila Therapeutics, and Phenomix Sciences; personal fees from Rhythm Pharmaceuticals, General Mills, Gila Therapeutics; he reports patent PCT. US 62/589,915 licensed to Phenomix Sciences. ACS reports institutional research grants from Boston Scientific, Enterasense, Endogenex; consulting fees from Olympus; consulting fees and research grants from Endo-TAGSS, and Apollo Endosurgery; Participation in Data Safety Monitoring Board with GI Dynamics, and ERBE. MR reports consultant roles with Boston Scientific, Fujifilm, Medtronic, Enterasense, and GI Windows; Consultant and research support from Cook Medical. DM reports financial support from SPATZ medical for statistical analysis for this trial. CCT reports institutional research grants from Aspire Bariatrics, ERBE, SPATZ; Royalties from Endosim, Enterasense; Consulting fees and research grants from Apollo Endosurgery, Boston Scientific, Covidien/ Medtronic, Fractyl, Fujifilm, GI Dynamics, Lumendi, Olympus, and USGI; Payment or honoraria from Boston Scientific and Olympus; Patents licensed to Boston Scientific, GI Windows, Enterasense, EnVision Endoscopy, Endosim; Participation in Data Safety Monitoring Board with GI Dynamics, Fractyl, USGI; Leadership or fiduciary role in other board with Enterasense, EnVision Endoscopy, GI Windows, ASGE Governing board, BlueFlame Healthcare Venture Fund; Stockholder in GI Windows, Enterasense, EnVision Endoscopy; has received equipment on loan from Fujifilm, Olympus, and Boston Scientific. All other authors report no conflict of interests.Ethical Approval: It was conducted under a US Food and Drug Administration (FDA) Investigational Device Exemption (IDE G160061), approved on 29-Jul-2016, in compliance with 21 CFR812

Adjustabilní intragastrické balóny v bariatrii – větší zastoupení respondentů ve srovnání s užitím neadjustabilních intragastrických balónů

Introduction: The degree of efficacy and duration of effect of the intragastric balloon (IGB) can be variable and unpredictable. The Spatz Adjustable Intragastric balloon (AIGB) was developed to extend implantation to 1 year, decrease the balloon volume for intolerance and increase the volume for a diminishing effect. The utility/efficacy and responder rate with the Spatz3 AIGB were the subjects of this study. Methods: The results of 227 consecutive patients, without exclusions, in 3 centres implanted with the Spatz3 AIGB were reviewed retrospectively. Mean BMI 35.9; mean weight 99.6 kg; mean Excess Body Weight Loss (EBWL) 30.6%; mean balloon volume 464ml (400–500 ml). Balloon volume adjustments were offered: downward adjustments for intolerance and upward adjustments for weight loss plateau. Results: 227 patients were implanted (mean 10.3 months) yielding a mean weight loss of 15.8 kg; mean 15.7% Total Body Weight Loss (TBWL) and 57.6% Excess Body Weight Loss (EBWL). Response (&gt; 25% EBWL) was achieved in 83.3% of the patients. Downward adjustments in 15 patients (mean 2.3 weeks; mean –120 ml) allowed 12/15 (80%) to continue IGB therapy for a mean of 8.8 months. Upward adjustments in 107 patients (mean of 4.7 months; mean +284ml) yielded an additional mean weight loss of 8.5 kg. The upward-adjusted group at extraction had a mean weight loss of 17.8 kg; 17.2% TBWL and 59.2% EBWL. Two gastric ulcers: one due to NSAIDs and one healed with downward adjustment. Conclusions: In this retrospective review of 227 consecutive Spatz3 AIGB patients, upward adjustments yielded a mean 8.5 kg extra weight loss for those with a weight loss plateau, and downward adjustments alleviated early intolerance in 80% of the patients. These two adjustment functions may be instrumental in yielding a response rate of 83.3%

Efficacy of Liraglutide to Prevent Weight Regain After Retrieval of an Adjustable Intra-gastric Balloon-a Case-Matched Study.

Weight regain after balloon retrieval is a concern with all intra-gastric balloons (IGBs). The aim of this study was to evaluate the efficacy of liraglutide, a glucagon-like peptide-1 (GLP-1) agonist, to prevent weight regain following IGB retrieval. This was a case-matched study of patients undergoing Spatz3 adjustable IGB (Spatz FGIA, Inc. NY, USA) at three outpatient clinics in Brazil between November 2015 and January 2019. Seventy-seven patients that opted to take liraglutide following IGB retrieval (IGB-L) were matched 1:1 to 198 patients that declined the medication-IGB-Alone (IGB-A). Propensity score adjustment was performed at the time of balloon retrieval on factors known to influence the choice of liraglutide. Weight and percent body fat (%BF) was measured at baseline and 9months after IGB retrieval. % BF is defined as the total mass of fat divided by total body mass, multiplied by 100. The primary outcome was weight regain, and the secondary outcome was change in %BF 9months after IGB retrieval. Propensity score matching yielded 53 matched pairs. Weight regain to the starting point was not observed in either group. There was significantly less weight regain in IGB-L compared to IGB-A, - 1.15 ± 0.94kg versus - 0.66 ± 0.99kg (p = 0.010) 9months after balloon retrieval. Additionally, %BF decline in IGB-L was superior to IGB-A - 10.83 ± 1.50 versus - 7.94 ± 2.02 (p < 0.01). There was no difference in weight regain or decline in %BF based on liraglutide dose. Liraglutide has an additive benefit with respect to efficacy and a reduction in body fat when commenced after IGB retrieval. Future randomized control studies will be needed to determine the optimal dose and duration of liraglutide to achieve superior outcomes.

Randomized Prospective Clinical Study of Spatz3® Adjustable Intragastric Balloon Treatment with a Control Group: a Large-Scale Brazilian Experiment.

To analyze the results regarding weight loss and complications related to the Spatz3® adjustable intragastric balloon (IGB) in Brazil. This randomized prospective study covered patients who had undergone treatment using a Spatz3® adjustable IGB between October 2016 and June 2018 at a private clinic in Rio de Janeiro, Brazil. The patients had a minimum body mass index (BMI) of 27kg/m2. The study examined complications of Spatz3® treatment and BMI reduction, percentage of total weight loss (%TWL), and % of excess weight loss (%EWL). One hundred eighty patients underwent a Spatz3® balloon implant in the period. The patients were randomly divided into one group in which the Spatz balloon was kept at the same volume (600mL) throughout treatment (Control Group), and another adjustment group with 250mL greater volume. The complication rate was 16.14%. No death or major complication occurred during the study. Mean BMI decreased from 39.51 to 32.84kg/m2 (p < 0.0001), bodyweight from 111.87 to 90.28kg (p< 0.0001), and excess weight from 41.55 to 22.99kg (p <0.0001). The adjustment resulted in greater mean weight loss of 4.35kg (- 8 to 17.6kg), and the average time of the procedure was 7.12 ± 1.63months. The upward adjustment group did not present greater %TWL, %EWL, or BMI reduction when compared with the control group (p = 0.4413, p = 0,9245, p = 0.2729, respectively). This study shows that Spatz3® IGB treatment is an effective procedure for weight reduction, with no mortality but higher morbidity compared with traditional IGBs. This procedure also enabled the balloon to stay in place for longer. The efficacy of upward adjustment still requires further confirmation.

ASSESSMENT OF WEIGHT LOSS AFTER NON-ADJUSTABLE AND ADJUSTABLE INTRAGASTRIC BALLOON USE.

Intragastric balloon (IGB) use is indicated for patients whose BMI precludes the option of bariatric surgery or who need to lose weight prior to undergoing surgery. It is a minimally invasive procedure and currently there are two main models of IGBs in use, the non-adjustable intragastric balloon (NIB), implanted for six months, and the adjustable intragastric balloon (AIB), implanted for up to 12 months. Analyze clinical characteristics between patients receiving non-adjustable gastric balloon and the adjustable (prolonged implantation) intragastric balloon. This was a cross-sectional study of 470 patients diagnosed as obese or overweight who had balloon implantation from October 2011 to July 2018. The associations between percentage excess weight loss versus clinical and demographic variables were calculated using the chi-squared test. Independent samples were submitted to the Student's t test to determine the quantitative variables, with a confidence interval of 95%. Calculation of excess weight was based on an estimated ideal weight that would correspond to a BMI of 24.99 kg/m2. A total of 414 patients completed the treatment achieving an average total body weight loss (%TBWL) of 15.4±7 with the NIB and 15.5±9.6 with the AIB. Overweight patients achieved higher excess weight loss (%EWL) values using AIBs (157.2±82.5) and obese patients did so with NIB use (56±29.7). Women achieved higher %EWL values (65.6±62.2) than men (48±27.1). Individuals who attended >4 consultations with a nutritionist (60.8%) achieved TBWL >18%. All of those P-values were <0.001. Obese individuals and women registered the greatest weight losses. Overweight patients achieved greater losses using AIB and obese patients did so using NIBs. NIB use was associated with higher EWL percentages. Nutritional accompaniment had a positive impact on the %TBWL.

Effect of Adjustable Intragastric Balloon in Obese Non-alcoholic Fatty Liver Disease

Effect of Adjustable Intragastric Balloon in Obese Non-alcoholic Fatty Liver Disease

2775 Intragastric Balloon Hyperinflation: A Rare Cause of a Palpable Abdominal Mass

INTRODUCTION: Intragastric balloons (IGB) are commonly being used for the treatment of obesity, with increasing data confirming their effectiveness. While usually well tolerated with rare adverse events, IGBs have been associated with complications including visceral perforation, pancreatitis and bowel obstruction. IGB hyperinflation, which occurs due to an abnormal accumulation of gas within IGB is rare. We present a case of a patient with abdominal pain and vomiting after recent IGB placement, found to have a palpable abdominal mass. CASE DESCRIPTION/METHODS: A 35-year-old female with class II obesity (BMI: 33 kg/m2) and recently placed adjustable IGB in the Dominican Republic presented to our emergency department with abdominal fullness, vomiting and inability to keep food down. The IGB had been placed for two months with reported 30 lbs weight loss. She denied fevers, dysphagia, hematemesis, melena or altered bowel movements. She was afebrile with normal vital signs. Physical examination revealed a palpable round-like mass in her epigastric region with tenderness to palpation. Laboratory workup, including complete blood count, basic metabolic panel, liver function tests and lipase were normal. CT scan of the abdomen and pelvis revealed a gas-filled hyperinflated IGB within the distal portion of the stomach with dilation proximally representing possible gastric outlet obstruction. There was no evidence of perforation or pneumatosis intestinalis [Figure 1a–c]. Due to her symptoms, and the patient’s wishes to have the balloon removed, endoscopy was performed. Endoscopy revealed a hyperinflated, adjustable IGB occupying two thirds of the gastric body and obstructing the gastric antrum. The balloon appeared mottled suggesting fungal colonization from the outside with food debris. Attention was then placed on balloon removal. Successful removal of 500cc of blue-colored fluid mixed with air was performed resulting in IGB deflation and subsequent retrieval. The patient did well with resolved symptoms and was discharged the next day. DISCUSSION: Intragastric balloon hyperinflation should be recognized as a possible complication of IGB placement and may be due to balloon permeability or gas-producing anaerobic bacteria. Patients usually present with nausea, vomiting and inability to tolerate oral intake and if left untreated can result in dire consequences. Imaging may assist with diagnosis. Treatment involves endoscopic IGB removal. In cases of adjustable IGB, deflation and fluid exchange can be considered.

Tu1902 – Prospective Study Investigating Changes in Gastric Emptying and Ghrelin After the Adjustable Intragastric Balloon

Tu1902 – Prospective Study Investigating Changes in Gastric Emptying and Ghrelin After the Adjustable Intragastric Balloon

A329 - Changes In Gastric Emptying With The Spatz3 Adjustable Intragastric Balloon Are Associated With Increased Weight Loss: A Prospective Study

A329 - Changes In Gastric Emptying With The Spatz3 Adjustable Intragastric Balloon Are Associated With Increased Weight Loss: A Prospective Study

Spatz3 Adjustable Balloon: Weight Loss and Response Rates in Brazil

Background: The degree of efficacy and duration of effect of Intragastric Balloons (IGBs) can be variable and unpredictable. The Spatz Adjustable Intragastric Balloon (AIGB) was developed to address these issues by extending implantation to 1 year, decreasing balloon volume for intolerance and increasing volume for decreased balloon effect.Aims: To determine the efficacy and response rate of the Spatz3 AIGB.Methods: Results of 379 consecutive patients (pts) implanted with the Spatz3 AIGB were retrospectively reviewed (3 lost to follow up). Mean BMI 35.5; mean weight (wt) 97.5 kg; mean excess wt 29.1 kg; mean balloon volume 600ml. Balloon volume adjustments were offered: Down adjustments for intolerance and up adjustments for decreased balloon effect.Results: The mean implantation time of 376 pts was 10.6 months yielding mean wt loss 14.9 kg; mean 15.1% Total Body Wt Loss (%TBL) and 58% Excess Wt Loss(%EWL). Response rate (&gt; 25%EWL) was achieved in 79% (297/376) of pts. Down adjustments in 95 pts (mean 2.4 months; mean -152.4 ml) allowed 76/95 (80%) to continue IGB therapy for at least 6 months (mean 9.1 months). Up adjustments in 205/376 (54.5%) pts (mean 5.8 months; mean + 179.2 ml) yielded additional mean wt loss of 6.5 kg. There was 1 gastric ulcer (0.27%). One balloon deflated at 7.4 months and 4 others deflated after 1 year (13-23 months).Conclusions: In this retrospective review of 376 Spatz3 AIGB patients, up adjustments yielded a mean 6.5kg extra wt loss for those with wt loss plateau, and down adjustments alleviated early intolerance. These two adjustment functions may be instrumental in yielding a successful outcome (&gt; 25% EWL) in 79% of pts.

Gastric Perforation as a complication of intragastric balloon

Obesity is considered the most common nutritional disorder in Western countries and is related to multiple morbidity and mortality. There are different options for obesity treatment, including diet, behavioral therapy, medications, and surgery. If patients do not meet the criteria for bariatric surgery, intragastric balloons may be used to achieve weight reduction. Currently, the intragastric balloon is one of the most common bariatric procedures in obese patients in Europe. Gastric perforation associated with intragastric balloon is a rare but dangerous complication. We report a case of a 42-year-old female patient who presented to the emergency department with acute abdomen. Chest x-ray in an erect posture indicated free gas under the diaphragm. She had undergone placement of an intragastric adjustable balloon device 13 months earlier and was overdue for removal of the balloon. In the emergency theater, a large perforated ulcer was found in the posterior wall of the stomach, which was repaired laparoscopically. Her postoperative course was uneventful. We also review the literature on intragastric balloon–induced gastric perforation. Our case is a very rare report of late gastric perforation after adjustable intragastric balloon placement. We recommend regular follow-up and removal in proper time after insertion of the gastric balloon.

Response Rates with the Spatz3 Adjustable Balloon

Intragastric balloons (IGBs) have demonstrated efficacy; however, the percent of "responders" (>25% estimated weight loss (EWL) or >10% total body weight loss (TBWL)-as suggested by FDA) have been less reported. The Spatz3 adjustable intragastric balloon (AIGB) extends implantation to 1year, decreases balloon volume for intolerance, and increases volume for diminishing effect. The aim of this study is to determine the efficacy/responder rate of the Spatz3 AIGB. Implantations of Spatz3 in 165 consecutive patients (pts) in 2 centers were retrospectively reviewed. Mean BMI is 35.7, mean weight (wt) 99.1kg, and mean balloon volume 495ml (400-600ml). Balloon volume adjustments were offered for intolerance and for wt loss plateau. In total, 165 pts were implanted yielding mean wt loss of 16.3kg, 16.4% TBWL, and 67.4% EWL. Response (>25% EWL; 10% TBWL) was achieved in 146/165 (88.5%) of patients. Response rates differed for 136 pts with BMI <40 (91.2%) and 29 pts with BMI >40 (69%). Down adjustments in 20 patients (mean -150ml) allowed 16/20 (80%) to continue IGB therapy. Up adjustments in 64 patients (mean 5.4months; mean +260ml) yielded additional mean wt loss of 5.7kg. One gastric perforation (0.6%) occurred in a patient who experienced abdominal pain for 2weeks. Five patients with small ulcers did not require balloon extraction. (1) Within the limitations of a retrospective review, the Spatz3 balloon appears to be an effective wt loss balloon with better response rates in BMI <40. (2) Up adjustments yielded a mean 5.7kg extra wt loss. (3) Down adjustments alleviated early intolerance in 80% of patients. (4) These two adjustment functions may be instrumental in yielding a responder rate of 88.5%.

1074 Adjustable Intragastric Balloon: Placement Technique and Review of Clincal Literature

1074 Adjustable Intragastric Balloon: Placement Technique and Review of Clincal Literature

612 - SPATZ3® Adjustable Intragastric Balloon Treatment: Twenty Four Months Experience in a Brazilian Private Center

612 - SPATZ3® Adjustable Intragastric Balloon Treatment: Twenty Four Months Experience in a Brazilian Private Center