Adjustable gastric balloons for weight loss – a higher yield of responders compared to non-adjustable gastric balloons

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 (> 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%