3
Endoscopic Sleeve Gastroplasty Procedure
Stomach
before ESG
Suturing
after ESG
Suturing device
inserted through
the mouth
Procedure
performed
without scars
Intragastric Balloons
➤ Mechanism: A balloon is inserted into stomach and filled with
air or saline.
➤ Indication: BMI >30 and <40 kg/m
2
; approved for six to eight
months in the US, 12 months in Europe.
➤ Course: All balloons are temporary and should be removed
within six to eight months.
➤ Efficacy: Modest, temporary weight loss, which can help reduce
weight and lower perioperative risks for procedures such as
joint replacement and ventral hernia repair.
➤ Outcomes: Often produces 7% to 14% TBWL at six to eight
months.
➤ US Food and Drug Administration (FDA)-approved balloons:
• Orbera balloon: Silicon balloon f illed with 400–600 mL of
saline. Endoscopic placement and removal may be performed
for up to six months in the US and 12 months in Europe.
Approximately 13% TBWL.
• Spatz3: Balloon composed of silicone and f illed with 350–800
mL of saline; placed endoscopically for up to 8–12 months.
Spatz3 is the only adjustable intragastric balloon. Endoscopy is
required to complete adjustments. TBWL 11–15%.
