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Introduction and aim: Intragastric balloon therapy is a temporary, minimally invasive method for inducing weight loss. Any balloon with a volume of 400 ml induces satiety and delayed gastric emptying. The aim of the present study was to demonstrate its safety and efficacy. Materials and methods: We analyzed the safety and effectiveness of balloon placement in relation to weight loss in 128 patients. Subgroups were compared through the Student’s t test, ANOVA test, and the chi-square test, depending on the type of variable and the number of groups evaluated. Statistical significance was set at a p ≤ 0.05 to evaluate weight loss. Results: Mean weight loss after balloon therapy was 10.7 kg, with only 2 cases of complications due to oral feeding intolerance. Mean length of time with the balloon was 8 months. There were no complications after 6 months, but no further weight loss either (p = 0.540). Final weight loss versus initial weight loss was significant (p = 0.000). There was greater weight loss in the group that attended the bimonthly control appointments than in the group that did not: 12.7 kg vs. 7.26 kg (p = 0.000). Conclusions: The rates of the adverse events of intolerance and complications were very low in our study, compared with results in the literature (1.6% vs. 4.7% and 0% vs. 3%, respectively). Intragastric balloon placement had better results when the patients attended the control appointments. Intragastric balloon therapy is a safe and efficacious method for reducing weight in patients with overweight and obesity. Resumen: Introducción y Objetivo: El balón intragástrico (BIG) es una terapia de mínima invasión temporal para inducir pérdida de peso. Cualquier balón con un volumen de 400 ml induce saciedad y retraso del vaciamiento gástrico. El objetivo de este estudio es demostrar su seguridad y eficacia. Material y Métodos: Analizamos la efectividad y seguridad en la pérdida de peso en 128 pacientes con balón. Se compararon subgrupos mediante la prueba t de student, ANOVA y Chi 2 dependido del tipo de variables y numero de grupos evaluados tomando una significancia estadística

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Un tratamiento correcto de la obesidad ha de comporta un programa de modificación de hábitos independientemente de la técnica que se indique, en especial si es mínimamente invasiva como el Balón Intragástrico (BIG). Se cifra la adherencia terapéutica de los pacientes obesos en menos del 50% a medio largo y plazo respecto a las medidas higiénico-dietéticas aconsejadas. Dado que los resultados obtenidos mediante la técnica de Balón Intragástrico han de verse influidos por la adherencia al programa de modificación de hábitos, revisamos las series publicadas en atención al programa propuesto junto al BIG y a su cumplimiento. Se observa que las series publicadas hasta la fecha ofrecen pocos detalles sobre los Programas Terapéuticos utilizados así como la adherencia de los pacientes a los mismos, y menos aún respecto al Plan de Seguimiento y la fidelidad del paciente. Concluimos la conveniencia de consensuar una estrategia de seguimiento, al menos durante los 6 meses que permanece colocado el BIG.

Introduction: intragastric balloons provide early satiety and thereby induce short-term weight loss. The aim of this study was to evaluate safety and short and medium-term effectiveness of gastric balloons associated to hypocaloric diet in obesity. Material and methods: from May 2004 to June 2011 91 obese patients, body mass index [BMI] 45.2 ± 7.2 kg/m² were prospectively followed after endoscopic implantation of a gastric balloon associated to restricted diet. Successful therapy was defined as percent loss of total weight (%LTW) ≥ 5% at six months after balloon placement and 6 and 12 months after their withdrawal. All analyses followed intention-to treat principles considering significant p-values < 0.05. Results: we placed 73 fluid-filled balloons (80.2%) and 18 air-filled ones (19.8%). Compared to baseline values, at 6-month 73.7% subjects succeeded, showing significant reductions in weight (13.3 ± 8.8 kg), BMI (5 ± 3.4 kg/m²) (p < 0.0001), with% LTW 11 ± 7%. Six and twelve months after retrieval 45.1% and 28.6% patients reached% LTW ≥ 5%. Short-term and medium-term effectiveness was negatively associated to obesity in first-grade relatives (p = 0.003 and p = 0.04). Higher weight loss 6 months after balloon placement independently predicted medium-term effectiveness (p = 0.0001). Mortality was absent but there were two spontaneous deflations of air-filled balloons and severe withdrawal difficulties in 8 patients, leading to surgery in one case. Retrieval complications associated to air-filled balloons (p = 0.0005). Conclusions: in obesity, effectiveness of gastric balloons associated to hypocaloric diet decreases over time. Complications occurred mainly in the retrieval endoscopic procedure and related to air-filled balloons.

Introducción: La obesidad es una enfermedad crónica para la que se investigan hoy múltiples caminos terapéuticos. Uno de ellos es el conjunto de técnicas poco agresivas que se han sumado al balón intragástrico. Objetivo: Revisar las técnicas mínimamente invasivas descritas en los últimos años para el tratamiento de la obesidad. Material y método: Se procede a revisar toda la bibliografía asequible a través de los buscadores habituales, además de la información obtenida de las casas comerciales. Se clasifican en restrictivas y malabsortivas, y las primeras en restricción mecánica o funcional. Resultado: Entre las técnicas emergentes clasificadas como restrictivas mecánicas incluimos el balón intragástrico ajustable, la prótesis intragástrica, la gastroplastia vertical endoluminal y la gastroplastia transoral. Para obtener una restricción funcional, tenemos el marcapaso gástrico y la toxina botulínica. Y por último, se describe el by-pass duodenoyeyunal endoluminal que sería una técnica malabsortiva. Discusión: Con menos de 10 años de existencia, parece que las técnicas descritas compensan su menor eficacia frente a las técnicas quirúrgicas, con la ausencia de modificaciones sustanciales en la anatomía del tubo digestivo. Ninguna de estas técnicas está exenta de riesgos y complicaciones. Conclusión: Tal como ya manifestó la SAGES en 2009, estas técnicas parecen tener un futuro prometedor, pero la escasez de datos actuales no nos permiten aún confirmar su utilidad en el tratamiento de la obesidad.Introduction: Obesity is a chronic disease for which several modalities of treatment are investigated today. One of them is the set of minimally aggressive techniques that have been added to the intragastric balloon. Objective: To review the minimally invasive techniques described in the last years for the treatment of obesity. Material and method: It consisted in reviewing the bibliography through the habitual finders, in addition to the obtained data of the companies. They are classified in restrictive and malabsortive, and the restrictive are divides in mechanical or functional restriction. Result: Between mechanical restrictive the classified as we included in the restrictive emergent techniques the adjustable intragastric balloon, the intragastric prosthesis, the vertical endoluminal gastroplasty and the transoral gastroplasty. In order to obtain a functional restriction, we have the gastric pacemaker and the botulinic toxin. And finally, the endoluminal duodenojejunal bypass is described as a malabsortive technique. Discussion: With less than 10 years of existence, it seems that the described techniques compensate their smaller effectiveness compared to the surgical techniques, with the absence of substantial modifications in the anatomy of the alimentary tract. None of these techniques is free of risks and complications.

Introducción: El Balón Intragástrico (BIG) es una técnica invasiva, no quirúrgica, de carácter temporal, para el tratamiento de la obesidad, cuyos resultados dependen en gran medida de la colaboración del paciente. Objetivo: El objetivo es adaptar el Consentimiento Informado propio de la cirugía bariátrica, a un método que reviste las características especiales descritas. Material y método: Se utiliza el Consentimiento Informado propuesto por la ASAC para cirugía bariátrica, así como 8 sentencias relacionadas con el BIG tal como se hallan en la base de datos WESTLAW ES. Resultado: La revisión de las sentencias define el tratamiento mediante BIB como tratamiento con intención curativa y no satisfactiva, con obligación de medios aunque no de resultados, por parte del médico tratante. Se han de respetar además las obligaciones de una información correcta y completa -incluyendo las pautas dietéticas a seguir-, así como de las alternativas terapéuticas posibles, y por fin, de una constancia del proceso por escrito. Conclusiones: El Consentimiento Informado es un importante documento médico-legal cuyo contenido debe tener en cuenta la jurisprudencia recientemente aparecida en el campo de las técnicas mínimamente invasivas para el tratamiento de la obesidad.Introduction: Intra-gastric balloon (IGB) is an invasive, temporary, non-surgical technique for the treatment of obesity. Its outcomes mainly depend on the patient's collaboration. Objective: The aim was to adapt the informed consent used for bariatric surgery to a method that has especial characteristics. Materials and methods: We used the informed consent proposed by ASAC for bariatric surgery and 8 statements related to IGB included in the WESTLAW ES database. Results: The review of the statements defines the IGB treatment as a curative-intended and non-satisfactive therapy with an obligation of the means used, but not the outcomes, by the treating physician. Moreover, the obligations of providing a correct and complete information -which includes the dietary regime- should be observed, as well as the possible therapeutic alternatives and finally, the proceeding used should be in written. Conclusions: The informed consent is a medico-legal document which content should consider the latest jurisprudence on the minimally invasive techniques for the treatment of obesity.

Background: Surgery is the only effective treatment for people with a body mass index (BMI) greater than 40 Kg/m² or even greater than 35 Kg/m² when some diseases like diabetes or hypertension appear. In order to minimize surgical risk and improve postoperative results, preoperative preparation it's very important. "Acute" preoperative weight loss just before surgery plays a crucial role in that preparation and can be achieved through different ways like a low calorie diet, a very low calorie diet or with the use of an intragastric balloon. The advantages or particularities of every one of them will be summarized in this article. Material and methods: Literature review of the benefits, risks and complications of preoperative weight loss through a low calorie diet, a very low calorie diet or intragastric balloon placement. Results: Seven of thirteen initially selected reports from Medline search were considered relevant, including a total 371 patients (240 patients treated with low calorie diet, 90 with very low calorie diet and 41 cases of intragastric balloon placement). We found that weight loss was greater in patients with very low calorie diets and intragastric balloon groups but with a slightly increase in morbidity and cost. Conclusion: Although there are no comparative studies, data from the literature results show that diets very low in calories are more effective and require less time than low-calorie diets and cheaper with fewer side effects than the intragastric balloon.Introducción: La cirugía es el único tratamiento efectivo para aquellas personas con un índice de masa corporal (IMC) superior a 40 kg/m² o incluso superior a 35 kg/m² cuando existen enfermedades asociadas como la diabetes o la hipertensión. La preparación preoperatoria de estos pacientes es fundamental para disminuir los riesgos del acto quirúrgico y mejorar los resultados postoperatorios. La pérdida "aguda" de peso previo a la cirugía, uno de los pilares fundamentales de dicha preparación, se puede conseguir por diferentes medios como son una dieta baja en calorías, una dieta muy baja en calorías o la colocación de un balón intragástrico. En el siguiente artículo analizaremos las ventajas e inconvenientes de cada uno de ellos. Material y métodos: Revisión de la literatura de los beneficios, riesgos y complicaciones de la pérdida de peso preoperatoria mediante la dieta baja en calorías, la dieta muy baja en calorías o la colocación del balón intragástrico. Resultados: Siete estudios fueron considerados relevantes, de los trece seleccionados inicialmente de la búsqueda en Medline, incluyendo un total de 371 pacientes (240 pacientes fueron tratados con una dieta baja en calorias, 90 con una dieta muy baja en calorias y a 41 se les implantó un balón intragástrico). La pérdida de peso fue mayor en los pacientes con una dieta muy baja en calorías y en los pacientes que se les colocó un balón intragástrico, sin embargo estos pacientes presentaron un ligero incremento en la morbilidad y los costes. Conclusión: Aunque no existen estudios comparativos, los resultados de la búsqueda bibliográfica sugieren que las dietas de muy bajo contenido calórico son más efectivas y necesitan menos tiempo que las dietas de bajo contenido calórico, y más económicas y con menos efectos secundarios que el balón intragástrico.

Background: The intragastric balloon is widely used for weight reduction in obese patients, but results are variable. We describe our results enhancing the importance of a Multidisciplinary Team (MT) taking part in the treatment. Methods: A retrospective review was done concerning a total of 119 balloons , placed in 116 patients, under endoscopic control and conscious sedation, from May 2001 until August 2006. 49 patients were prepared and recommended to be followed by a MT in a physical unit, at least every 15 days during 6 months. 67 were indicated and followed by other colleagues, without MT. Removal was performed 6 months later. Results: Concerning our 49 patients, mean age was 38, 1 years, 31 female and 18 males, with BMI ranged between 32 and 63, average of 42. The average decrease of weight excess was 31, 85% (-4, 45-80, 4%), and the BMI diminished 5,3 points (from 13,6 to gain of 0,9). The treatment failed in 34,6 % of our patients -including 4 patients lost of follow-up (8, 16%)-, compared with 53, 8% of patients without structured MT for selection and follow-up. Physical exercise enhanced markedly the results with 45, 8% of excess of weight loss in women and 39, 7% in males, compared with 14, 6 and 15, 6% in patients who didn't follow the program. The weight loss was mostly fat mass, 89,9% in men and 75,6% in women.- The results maintenance was obtained in 40% of patients one year later. There were no major complications; one balloon had to be removed at 3 weeks because of intolerance, another at 5 months because of gastroesophageal reflux. Conclusions: BIB is an effective help to achieve a short term weight loss in obese patients; nevertheless, good and long lasting results will depend on the modification of life style obtained by a multidisciplinary approach.Antecedentes: el balón intragástrico se usa ampliamente para la reducción de peso de pacientes obesos pero sus resultados son variables. Describimos nuestros resultados resaltando la importancia de la implicación del equipo multidisciplinar (EM) en el tratamiento. Métodos: Se realiza una revisión retrospectiva correspondiente a 119 balones colocados a 116 pacientes bajo control endoscópico y sedación consciente desde mayo de 2001 a agosto de 2006. Se preparó a 49 pacientes a los que se recomendó seguimiento por un EM en una unidad física, al menos cada 15 días durante 6 meses. Se indicó a 67, que fueron seguidos por otros colegas, sin un EM. Se realizó la retirada 6 meses después. Resultados: Con respecto a nuestros 49 pacientes, la edad media fue de 38,1 años, hubo 31 mujeres y 18 hombres, con un IMC en el rango de 32-63, media de 42. El descenso medio de exceso de peso fue de 31,85% (-4,45- 80,4%), y el IMC disminuyó en 5,3 puntos (desde 13,6 a una ganancia de 0,9). El tratamiento fracasó en el 34,6% de nuestros pacientes -incluyendo 4 pacientes (8,16%) en quienes se perdió el seguimiento- en comparación con el 53,8% de pacientes sin unEMestructurado para la selección y el seguimiento. El ejercicio físico aumentó significativamente los resultados con un 45,8% de exceso de pérdida de peso en las mujeres y un 39,7% en los hombres, en comparación con el 14,6 y 15,6% en los pacientes que no siguieron el programa. La pérdida de peso fue sobre todo de masa grasa, 89,9% en los hombres y 75,6% en las mujeres. Los resultados se mantuvieron en el 40% de los pacientes un año después. No hubo complicaciones importantes; se tuvo que retirar un balón a las 3 semanas por intolerancia, y otro a los 5 meses por reflujo gastroesofágicoo. Conclusiones: El BIG es una ayuda eficaz para conseguir una pérdida de peso en el corto plazo en pacientes obesos; sin embargo, los resultados buenos y duraderos dependerán de la modificación del estilo de vida obtenida mediante un abordaje multidisciplinar.

La obesidad es considerada una enfermedad crónica, epidémica, y de difícil tratamiento. Ante el alto índice de fracasos de los métodos conservadores, y por otra parte, la inevitable morbimortalidad y secuelas ligadas a la cirugía, surgen nuevas técnicas poco invasivas destinadas a contribuir al tratamiento de esta enfermedad. La más implantada actualmente es el Balón Intragástrico, considerado más eficaz que el tratamiento conservador, con menos riesgo que la cirugía pero que adolece a día de hoy de una falta de consenso sobre sus indicaciones y escasa información sobre sus limitaciones, al tiempo que su aparición mediática ha propiciado su gran difusión en los 4 últimos años. En este trabajo se realiza una revisión crítica y se señalan las limitaciones de este tratamiento con base a la evidencia aportada por los estudios publicados hasta la fecha. Como conclusión de dicha revisión, se emiten una serie de recomendaciones respecto a la técnica y sus indicaciones, requisitos materiales y humanos, necesidad de Equipo Multidisciplinar así como del control y seguimiento adecuados.Obesity is considered a chronic and epidemic illness, hece difficult to treat. As conservative treatment has a high rate of failure, and considering morbimortality and sequels of surgery, less invasive techniques appeared to contributeto the treatment of this illness. The most implanted technique nowadays is the Intragastric Balloon, considered more efficient as conservative treat ments and with less risks tan surgery, but having today a lack of consensus on indications and few information on his limitations, while its apparition in medias promote an important expansion in the 4 last years. In this publication, we do a critical revision, and describe limitations of this treatment, based on the evidences given by literature. We conclude this revision with some recommendations concerning the technique and indications, material and human requiring, need of a Multidisciplinary Team, as well as an adequate control and following.

La obesidad se ha incrementado a nivel mundial, afectando a personas de todas las edades, constituyendo un grave problema de salud pública. Existen diversos tipos de tratamiento para la obesidad: dietético, farmacológico, entrenamiento físico, psicoterapia y quirúrgico. Se ha propuesto la colocación de un dispositivo de silicona similar a una esfera con una cantidad de 600ml denominado "balón intragástrico" indicado en pacientes con un índice de masa corporal superior a 30 kg/m². Objetivo: Evaluar el efecto del Balón Intragástrico como método alternativo en la pérdida de peso en pacientes obesos. Metodología: Estudio de tipo exploratorio, descriptivo, longitudinal y experimental. La muestra está constituida por 40 personas obesas. Se realizaron mediciones antropométricas de peso, talla, circunferencia abdominal y braquial, pliegues tricipital y subescapular; se calculó índice de masa corporal (IMC), área muscular y área grasa; al inicio, primero, tercer y sexto mes de la colocación del balón. Resultados: Muestra conformada por 31 mujeres (77,5%) y 9 hombres (22,5%). El promedio de edad del sexo femenino fue 35,87 años, y del masculino 44,67 años. Al momento de finalizar el estudio se registró una pérdida total de peso promedio de 18,25 kg, IMC 5,95 kg/m², circunferencia de cintura 13,53 cm y circunferencia braquial 4,14 cm en ambos sexos; la disminución de las medidas antropométricas fue mayor en los hombres que en las mujeres. Conclusiones: El balón intragástrico resultó ser un método efectivo en la pérdida de peso en pacientes obesos; con mejor resultado en los hombres que en las mujeres.Obesity has increased worldwide affecting people of all ages and accounting for a severe public health problem. There exist several treatment options for obesity: dietary, pharmacological, physical exercising, psychotherapy, and surgical. Placement of the so-called intragastric ballonn, a silicone device similar to a 600-mL sphere, has been proposed, indicated for patients with a body mass index higher than 30 kg/m². Objective: To assess the effect of the intragastric balloon as an alternative method for weight loosing in obese patients. Methodology: Longitudinal, experimental, descriptive, and exploring study. The sample includes 40 obese patients. Anthropometrical measurements including weight, height, abdominal circumference, tricipital and subscapular folds were done; the body mass index (BMI), muscle surface area and fat a surface area were calculated at baseline, first, third and sixth months after balloon placement. Results: The sample comprised 31 women (77.5%) y 9 men (22.5%). The mean age for women was 35.87 years, and for men 44.67 years. At the end of the study, there was a total mean weight reduction of 18.25 kg, BMI 5.95 kg/m², abdominal circumference 13.53 cm, and arm circumference 4.14 cm, in both genders; the decrease in anthropometrical measurements was higher in men than women. Conclusions: The intragastric balloon showed to be an effective method for weight loosing in obese patients, with better outcomes in men than women.

Introducción: la implantación de un balón intragástrico (BI) por vía endoscópica asociado a una dieta hipocalórica es una alternativa en el tratamiento de la obesidad. El objetivo de nuestro estudio es evaluar su efectividad, seguridad y tolerancia. Material y métodos: se incluyen de manera prospectiva 38 pacientes sin contraindicaciones para la implantación del BI, desde marzo de 2004 hasta enero de 2007. La retirada del balón se realizó 6 meses después de la implantación. Evaluamos el peso e índice de masa corporal (IMC) tras la retirada del balón, a los 6 y 12 meses postretirada, así como la tolerancia y aparición de complicaciones durante el tratamiento. Tras la retirada del balón se realizó un cuestionario a cada paciente evaluando la percepción subjetiva al tratamiento. Resultados: después de 6 meses de tratamiento la pérdida de peso media fue de 14,10 kg (0-46) y la reducción media del IMC fue de 5,23 kg/m² (0-18). A los 12 meses postretirada del balón el 48,4% de pacientes mantiene o sigue perdiendo peso. Los síntomas precoces más frecuentes fueron náuseas (71,1%) y vómitos (57,9%), con buena respuesta a tratamiento sintomático. Presentaron complicaciones 7 pacientes (18,4%): intolerancia digestiva en 4 pacientes, requiriendo retirada precoz del balón en 3 de ellos; esofagitis moderada en 2 pacientes; y perforación gástrica complicada con shock séptico y exitus en 1 paciente. Conclusiones: 1. El balón intragástrico asociado a una dieta hipocalórica puede considerarse un tratamiento efectivo, seguro y bien tolerado para el tratamiento de pacientes con obesidad mórbida. 2. La pérdida de peso se mantiene en casi la mitad de los pacientes al año tras la retirada del balón.Introduction: the endoscopic placement of an intragastric balloon (IGB) in association with a low-calorie diet is an option for the treatment of obesity. The aim of the present study was to evaluate its effectiveness, safety, and tolerance. Material and methods: thirty-eight patients with no contraindications for IGB were included in this prospective study from March 2004 to January 2007. Balloon removal was performed 6 months later. Weight and body mass index (BMI) were evaluated after IGB removal and at 6 months and 1 year thereafter. Tolerance and complications during treatment were evaluated. Patients filled out a questionnaire to evaluate their subjective perception of treatment. Results: mean weight loss after 6 months on balloon treatment was 14.10 kg (0-46), and mean BMI reduction was 5.23 kg/m² (0-18). At 12 months after balloon removal 48.4% of patients maintained their weight loss or kept loosing weight. Most common early symptoms included nausea (71.1%) and vomiting (57.9%) with a good response to symptomatic treatment. Complications were seen in 7 patients (18.4%): digestive intolerance in 4 patients, with early removal in 3 of them; moderate esophagitis in 2 patients; and gastric perforation complicated with septic shock and death in 1 patient. Conclusions: 1. IGB in association with low-calorie diet is an effective, safe, and well tolerated treatment for morbid obese patients. 2. Almost half of patients maintained their weight loss after one year from balloon removal.

Obesity can be defined in general terms as a state of excessive adipose tissue mass, which is usually classified by the body mass index (BMI). Central obesity is associated with an increased risk of developing metabolic syndrome and cardiovascular disease. The incidence of this disease had increased in recent decades. In 2008 in the US it was reported that 39% of the population over 20 years were obese. In Mexico, according to the National Health and Nutrition Survey 2012 (ENSANUT 2012) the prevalence of obesity in adolescents was 35.8% for females and 34.1% in males, finding an overall prevalence of 79.3% (64.5 % and 82.4% respectively in men and women). The surgical treatment is reserved for patients who do not respond to intensive medical management. A group of intermediate patients who are not candidates for surgical treatment and do not respond to medical treatment a treatment option is the intragastric balloon placement. The complications associated with the use of this device are increased with prolonged use and lack monitoring by the patient. The main complications are high intestinal obstruction, migration ball and intermittent chronic pain. [ABSTRACT FROM AUTHOR]

Since de Tarpon Springs Consensus Conference in 1987, the Bioenterics Intragastric Balloon represents the standard model for obesity treatment with this technique. Nevertheless, over the last 30 years, especially for the last ten years, novel concept of balloons has appeared, as well as new alternative models, which are reviewed in this paper. [ABSTRACT FROM AUTHOR]

A correct treatment of obesity needs a program of habits modification regardless of the selected technique, especially if it is minimally invasive as the intragastric balloon (BIG). The adherence of the obese patients with regard to recommended drugs measures to medium- and long-term is less than 50%. Given that the results obtained using the technique of gastric balloon must be seen influenced by adherence to the modification of habits program and its fulfillment, we reviewed series published in attention to the program proposed with the BIG. The series published to date provide few details about the used Therapeutic Programs as well as the adherence of patients to them, and even less concerning the Monitoring Plan and the loyalty of the patient can be seen. We conclude the convenience to agree on a follow-up strategy, at least the 6 months during which the BIG remain in the stomach. [ABSTRACT FROM AUTHOR]

El balón intragástrico es un procedimiento no quirúrgico indicado para el control de la obesidad. En el presente estudio se describe la experiencia de los primeros 100 casos en Paraguay, donde se estima un 32% de obesidad en la población urbana. El objeto de estudio fue determinar la eficacia del balón intragástrico en el descenso ponderal y de circunferencia de cintura de los pacientes obesos sometidos a este tratamiento. Desde octubre del 2004 hasta diciembre de 2008 se han sometido 100 pacientes obesos a la colocación del balón intragástrico luego de una evaluación clínica, sicológica y nutricional. Recibieron dieta hipocalórica e indicación de actividad física diaria. En el análisis de los resultados los valores de peso disminuyeron significativamente después de la intervención siendo los valores de la mediana de 112 (IC 95%: 96,4 a 113,9 Kg; p< 0,0001) a nivel inicial y de 88 (IC 95%: 80,0 a 89,3) a nivel final, dándonos una diferencia neta de 24 Kg en un periodo de seis a ocho meses. En cuanto al índice de masa corporal (IMC), el cambio observado fue un grado de obesidad de diferencia, pasando de obesidad mórbida y grado III a obesidad grado II y I. Los valores fueron los siguientes: mediana de 38 Kg/m2 (IC 95%: 36,4 a 39,9) en el nivel inicial y en el final, mediana de 31,0 Kg/ m2 (IC 95% 29,4 a 33,9). Los resultados muestran una pérdida significativa de peso, IMC y diámetro de cintura. Esto se logra combinando el balón intragástrico, dieta restringida y terapia de apoyo conductual

Introduction: Obesity is a chronic disease for which several modalities of treatment are investigated today. One of them is the set of minimally aggressive techniques that have been added to the intragastric balloon. Objective: To review the minimally invasive techniques described in the last years for the treatment of obesity. Material and method: It consisted in reviewing the bibliography through the habitual finders, in addition to the obtained data of the companies. They are classified in restrictive and malabsortive, and the restrictive are divides in mechanical or functional restriction. Result: Between mechanical restrictive the classified as we included in the restrictive emergent techniques the adjustable intragastric balloon, the intragastric prosthesis, the vertical endoluminal gastroplasty and the transoral gastroplasty. In order to obtain a functional restriction, we have the gastric pacemaker and the botulinic toxin. And finally, the endoluminal duodenojejunal bypass is described as a malabsortive technique. Discussion: With less than 10 years of existence, it seems that the described techniques compensate their smaller effectiveness compared to the surgical techniques, with the absence of substantial modifications in the anatomy of the alimentary tract. None of these techniques is free of risks and complications. [ABSTRACT FROM AUTHOR]

Introduction: Intra-gastric balloon (IGB) is an invasive, temporary, non-surgical technique for the treatment of obesity. Its outcomes mainly depend on the patient's collaboration. Objective: The aim was to adapt the informed consent used for bariatric surgery to a method that has especial characteristics. Materials and methods: We used the informed consent proposed by ASAC for bariatric surgery and 8 statements related to IGB included in the WESTLAW ES database. Results: The review of the statements defines the IGB treatment as a curative-intended and non-satisfactive therapy with an obligation of the means used, but not the outcomes, by the treating physician. Moreover, the obligations of providing a correct and complete information -- which includes the dietary regime -- should be observed, as well as the possible therapeutic alternatives and finally, the proceeding used should be in written. Conclusions: The informed consent is a medico-legal document which content should consider the latest jurisprudence on the minimally invasive techniques for the treatment of obesity. [ABSTRACT FROM AUTHOR]

Background: Surgery is the only effective treatment for people with a body mass index (BMI) greater than 40 Kg/m²or even greater than 35 Kg/m²when some diseases like diabetes or hypertension appear. In order to minimize surgical risk and improve postoperative results, preoperative preparation it's very important. "Acute" preoperative weight loss just before surgery plays a crucial role in that preparation and can be achieved through different ways like a low calorie diet, a very low calorie diet or with the use of an intragastric balloon. The advantages or particularities of every one of them will be summarized in this article. Material and methods: Literature review of the benefits, risks and complications of preoperative weight loss through a low calorie diet, a very low calorie diet or intragastric balloon placement. Results: Seven of thirteen initially selected reports from Medline search were considered relevant, including a total 371 patients (240 patients treated with low calorie diet, 90 with very low calorie diet and 41 cases of intragastric balloon placement). We found that weight loss was greater in patients with very low calorie diets and intragastric balloon groups but with a slightly increase in morbidity and cost. Conclusion: Although there are no comparative studies, data from the literature results show that diets very low in calories are more effective and require less time than low-calorie diets and cheaper with fewer side effects than the intragastric balloon. [ABSTRACT FROM AUTHOR]

Background: The intragastric balloon is widely used for weight reduction in obese patients, but results are variable. We describe our results enhancing the importance of a Multidisciplinary Team (MT) taking part in the treatment. Methods: A retrospective review was done concerning a total of 119 balloons , placed in 116 patients, under endoscopic control and conscious sedation, from May 2001 until August 2006. 49 patients were prepared and recommended to be followed by a MT in a physical unit, at least every 15 days during 6 months. 67 were indicated and followed by other colleagues, without MT. Removal was performed 6 months later. Results: Concerning our 49 patients, mean age was 38, 1 years, 31 female and 18 males, with BMI ranged between 32 and 63, average of 42. The average decrease of weight excess was 31, 85% (-4, 45-80, 4%), and the BMI diminished 5,3 points (from 13,6 to gain of 0,9). The treatment failed in 34,6 % of our patients —including 4 patients lost of follow-up (8, 16%)—, compared with 53, 8% of patients without structured MT for selection and follow-up. Physical exercise enhanced markedly the results with 45,8% of excess of weight loss in women and 39, 7% in males, compared with 14, 6 and 15, 6% in patients who didn't follow the program. The weight loss was mostly fat mass, 89,9% in men and 75,6% in women. The results maintenance was obtained in 40% of patients one year later. There were no major complications; one balloon had to be removed at 3 weeks because of intolerance, another at 5 months because of gastroesophageal reflux. Conclusions: BIB is an effective help to achieve a short term weight loss in obese patients; nevertheless, good and long lasting results will depend on the modification of life style obtained by a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Obesity is considered a chronic and epidemic illness, hence difficult to treat. As conservative treatment has a high rate of failure, and considering morbimortality and sequels of surgery, less invasive techniques appeared to contribute to the treatment of this illness. The most implanted technique nowadays is the Intragastric Balloon, considered more efficient as conservative treatments and with less risks than surgery, but having today a lack of consensus on indications and little information on its limitations, while its apparition in medias promote an important expansion in the 4 last years. In this publication, we do a critical revision, and describe limitations of this treatment, based on the evidence given by literature. We conclude this revision with some recommendations concerning the technique and indications, material and human requiring, need of a Multidisciplinary Team, as well as an adequate control and following. [ABSTRACT FROM AUTHOR]

Obesity has increased worldwide affecting people of all ages and accounting for a severe public health problem. There exist several treatment options for obesity: dietary, pharmacological, physical exercising, psychotherapy, and surgical. Placement of the so-called intragastric ballonn, a silicone device similar to a 600-mL sphere, has been proposed, indicated for patients with a body mass index higher than 30 kg/m². Objective: To assess the effect of the intragastric balloon as an alternative method for weight loosing in obese patients. Methodology: Longitudinal, experimental, descriptive, and exploring study. The sample includes 40 obese patients. Anthropometrical measurements including weight, height, abdominal circumference, tricipital and subscapular folds were done; the body mass index (BMI), muscle surface area and fat a surface area were calculated at baseline, first, third and sixth months after balloon placement. Results: The sample comprised 31 women (77.5%) y 9 men (22.5%). The mean age for women was 35.87 years, and for men 44.67 years. At the end of the study, there was a total mean weight reduction of 18.25 kg, BMI 5.95 kg/m², abdominal circumference 13.53 cm, and arm circumference 4.14 cm, in both genders; the decrease in anthropometrical measurements was higher in men than women. Conclusions: The intragastric balloon showed to be an effective method for weight loosing in obese patients, with better outcomes in men than women. [ABSTRACT FROM AUTHOR]

Introduction and Aim: Intragastric balloon therapy is a temporary, minimally invasive method for inducing weight loss. Any balloon with a volume of 400mL induces satiety and delayed gastric emptying. The aim of the present study was to demonstrate its safety and efficacy., Materials and Methods: We analyzed the safety and effectiveness of balloon placement in relation to weight loss in 128patients. Subgroups were compared through the Student's t test, ANOVA test, and the chi-square test, depending on the type of variable and the number of groups evaluated. Statistical significance was set at a P≤.05 to evaluate weight loss., Results: Mean weight loss after balloon therapy was 10.7kg, with only 2 cases of complications due to oral feeding intolerance. Mean length of time with the balloon was 8months. There were no complications after 6months, but no further weight loss either (P=.540). Final weight loss versus initial weight loss was significant (P=.000). There was greater weight loss in the group that attended the bimonthly control appointments than in the group that did not: 12.7kg vs. 7.26kg (P=.000)., Conclusions: The rates of the adverse events of intolerance and complications were very low in our study, compared with results in the literature: 1.6% vs. 4.7% and 0% vs. 3%, respectively. Intragastric balloon placement had better results when the patients attended the control appointments. Intragastric balloon therapy is a safe and efficacious method for reducing weight in patients with overweight and obesity., (Publicado por Masson Doyma México S.A.)

Objective: Review and determination of ideal characteristics for the management of obesity by intragastric balloon, in Monterrey, Mexico., Method: Retrospective analysis of 152 patients, with overweight and obesity from January 2009 to December 2015, to whom an intragastric balloon was placed. Demography, weight loss, decrease in body mass index (BMI) and complications were analyzed. The objective was to determine the group of patients that will benefit the most after endoscopic intragastric balloon placement., Results: A sample of 120 women and 32 men was analyzed. As expected, greater weight loss was observed in patients with BMI > 40 (n = 10, 6.57%, m = 26.29 ± 5.69; p = 0.001) and the lowest in patients with a BMI < 29.9 (n = 24, 15.78 %). Greater satisfaction was detected among patients with an average loss of 15.24 ± 2.75 kg (p < 0.001), and greater indifference among patients with greater losses. There is a tendency among women towards dissatisfaction., Conclusions: The greatest weight loss was observed among patients with a BMI > 40, although the highest satisfaction was observed among men with an average BMI of 32, which is why we recommend the procedure for these patients. We consider it to be an excellent bridge procedure for patients with BMI > 50., (Copyright: © 2019 Permanyer.)

Background: The intragastric balloon is widely used for weight reduction in obese patients, but results are variable. We describe our results enhancing the importance of a Multidisciplinary Team (MT) taking part in the treatment. Methods: A retrospective review was done concerning a total of 119 balloons , placed in 116 patients, under endoscopic control and conscious sedation, from May 2001 until August 2006. 49 patients were prepared and recommended to be followed by a MT in a physical unit, at least every 15 days during 6 months. 67 were indicated and followed by other colleagues, without MT. Removal was performed 6 months later. Results: Concerning our 49 patients, mean age was 38, 1 years, 31 female and 18 males, with BMI ranged between 32 and 63, average of 42. The average decrease of weight excess was 31, 85% (-4, 45-80, 4%), and the BMI diminished 5,3 points (from 13,6 to gain of 0,9). The treatment failed in 34,6 % of our patients -including 4 patients lost of follow-up (8, 16%)-, compared with 53, 8% of patients without structured MT for selection and follow-up. Physical exercise enhanced markedly the results with 45, 8% of excess of weight loss in women and 39, 7% in males, compared with 14, 6 and 15, 6% in patients who didn't follow the program. The weight loss was mostly fat mass, 89,9% in men and 75,6% in women.- The results maintenance was obtained in 40% of patients one year later. There were no major complications; one balloon had to be removed at 3 weeks because of intolerance, another at 5 months because of gastroesophageal reflux. Conclusions: BIB is an effective help to achieve a short term weight loss in obese patients; nevertheless, good and long lasting results will depend on the modification of life style obtained by a multidisciplinary approach.

La obesidad es considerada una enfermedad crónica, epidémica, y de difícil tratamiento. Ante el alto índice de fracasos de los métodos conservadores, y por otra parte, la inevitable morbimortalidad y secuelas ligadas a la cirugía, surgen nuevas técnicas poco invasivas destinadas a contribuir al tratamiento de esta enfermedad. La más implantada actualmente es el Balón Intragástrico, considerado más eficaz que el tratamiento conservador, con menos riesgo que la cirugía pero que adolece a día de hoy de una falta de consenso sobre sus indicaciones y escasa información sobre sus limitaciones, al tiempo que su aparición mediática ha propiciado su gran difusión en los 4 últimos años. En este trabajo se realiza una revisión crítica y se señalan las limitaciones de este tratamiento con base a la evidencia aportada por los estudios publicados hasta la fecha. Como conclusión de dicha revisión, se emiten una serie de recomendaciones respecto a la técnica y sus indicaciones, requisitos materiales y humanos, necesidad de Equipo Multidisciplinar así como del control y seguimiento adecuados.

Background: Surgery is the only effective treatment for people with a body mass index (BMI) greater than 40 Kg/m² or even greater than 35 Kg/m² when some diseases like diabetes or hypertension appear. In order to minimize surgical risk and improve postoperative results, preoperative preparation it's very important. "Acute" preoperative weight loss just before surgery plays a crucial role in that preparation and can be achieved through different ways like a low calorie diet, a very low calorie diet or with the use of an intragastric balloon. The advantages or particularities of every one of them will be summarized in this article. Material and methods: Literature review of the benefits, risks and complications of preoperative weight loss through a low calorie diet, a very low calorie diet or intragastric balloon placement. Results: Seven of thirteen initially selected reports from Medline search were considered relevant, including a total 371 patients (240 patients treated with low calorie diet, 90 with very low calorie diet and 41 cases of intragastric balloon placement). We found that weight loss was greater in patients with very low calorie diets and intragastric balloon groups but with a slightly increase in morbidity and cost. Conclusion: Although there are no comparative studies, data from the literature results show that diets very low in calories are more effective and require less time than low-calorie diets and cheaper with fewer side effects than the intragastric balloon.