30/01/2023
Gastric Balloon

Intragastric balloon insertion – 2022

gastric balloon

Intragastric balloon insertion

Generally, both the insertion and the removal of the intragastric balloon are carried out under light sedation; only in selected cases, and…

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INTRAGASTRIC BALLOON TURIN

The intragastric balloon is a technique for the temporary treatment of obesity and consists in the application in the stomach for a period of about six months of a balloon that induces weight loss thanks to specific mechanisms of action, including a slowing of gastric emptying and a more effective stimulation of the satiety center through the baroreceptors present on the gastric walls, and not a placebo effect.

Candidates

The main candidates for the application of the intragastric balloon are patients who are expected to have bariatric surgery shortly and who therefore need to lose weight urgently to reduce the risk associated with anesthesia and the operation, as well as to facilitate the operation itself. from a technical point of view.

Although this technique cannot help to improve the effects of the surgery itself, nor to directly identify the most suitable patients for it, it can nevertheless contribute to this decision as a negative test: those who in fact failed to obtain results of satisfactory weight loss with the application of the intragastric balloon should be directed towards treatments other than those aimed at reducing food intake, or be subjected to more careful information and evaluation.

According to some specialists (psychologists, psychiatrists, dieticians), in fact, the application of the intragastric balloon would constitute a “stress test” that could give indications on the type of intervention most suitable for the obese subject in question.

Contraindications

The insertion of the intragastric balloon may have contraindications, in the case of previous abdominal surgery (especially gastric), peptic disease in progress, drug addiction and psychological discomfort, hiatal hernias, gastro-oesophageal reflux, severe liver, heart or lung diseases or chronic inflammation of the intestine. Once the absence of these unfavorable conditions has been ascertained, the prosthesis is positioned and expanded under endoscopic control.

Intragastric balloon insertion

Generally, both the insertion and the removal of the intragastric balloon are carried out under light sedation; only in selected cases, and especially for removal, can deep sedation or general anesthesia be used.
More rarely, the intragastric balloon is placed in the X-ray room without endoscopic control, even if an esophagogastroduodenoscopy is performed before admission. An x-ray examination during the follow-up process may be useful, although it is not necessary at the time of discharge from the clinic.

Post-operative course

Following the operation, the patient is usually hospitalized and subjected to the usual therapeutic treatments, as well as standard parenteral hydration (2500 ml). From the second day the parenteral treatment is reduced, then completely suspended from the third day, and a liquid diet is introduced. From the third day on, a light diet is also passed and antiemetic and antispasmodic drugs are administered only in case of need. As soon as the patient demonstrates that he can tolerate normal nutrition without emetic episodes, he is discharged with the relative pharmacological and dietary prescriptions. Very often the discharge takes place in even shorter times.

Checks

Then the patient is checked cyclically with follow-up visits, sometimes not entrusted to the bariatric surgeon but delegated to the dietician.

In some exceptional cases, if the patient refuses surgery, a second or third balloon can be applied after six months, which however lead to a lower weight loss.

When it is not recommended

The use of this prosthesis is not recommended for patients not suffering from severe obesity or superobesity, but it can be considered below the canonical criteria for selected cases or specific requests of the team of therapists, however in the context of a long-term multidisciplinary treatment of obesity. A greater diffusion of this technique even for patients not suffering from clinical obesity could be desirable, especially if in combination with modern drugs that have been shown to have greater tolerability over time, but for the moment this hypothesis is still being studied and Research.

 

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