After undergoing pre-surgery tests and consultations, you can schedule your intragastric balloon procedure. Before the surgery, your doctor would advise you to consume only liquids and take acid reflux medicine.
This is a training phase for developing new behaviors that will last long after the balloon has been removed.
How the Procedure Works
The endoscopist slides the endoscope down your throat and into the stomach. This is a minimally invasive procedure. No incisions are needed, so the risks of complications are low.
Next, the endoscopist inserts the Orbera balloon. It is filled with saline. It is a smaller balloon than the gastric bypass, and it takes up less space in your stomach. The Orbera gastric balloon sits near the pylorus, the valve at the bottom of the stomach. Food and liquids move more slowly through the stomach as a result.
Your stomach is filled to the top third by the balloon. It also teaches your body to consume smaller meals, making you feel full. You will collaborate with your care team to develop a healthy eating plan. To monitor your success, you will need to keep a food journal.
There have been 18 reports of death from the Orbera balloon since its launch in 2016. More research is needed to understand this issue. A more common adverse event is spontaneous hyperinflation, in which the balloon overfills itself sometime after insertion. This requires another endoscopy to inspect and remove the device. Other potential side effects include gastrointestinal issues, esophageal tears, and pulmonary perforation. The only way to prevent these complications is to follow the doctor’s instructions closely and not chew gum or eat solid foods.
Preparation
Contrary to invasive bariatric surgery, Orbera balloon installation is completed outside of the hospital while under anesthesia and without the need for abdominal incisions. The doctor will examine you physically and review your medical history to establish whether you are a candidate for the intragastric balloon treatment. You are not eligible for Orbera if you have had gastric bypass surgery, gastrointestinal ulcers, or a hiatal hernia larger than 5 cm. Also, the balloon is unsuitable for pregnant women or those planning to become pregnant within six months of balloon placement.
The procedure takes 20-30 minutes, and you will be sedated. The gastroenterologist or endoscopic surgeon will insert the flexible telescope into your throat and stomach. The Orbera balloon will then be inserted and filled with saline until it is the size of a grapefruit.
Once inserted, the Orbera balloon occupies excess space in your stomach, making you feel full quickly and helping to reinforce proper portion sizes. After the balloon has been removed for six months, you will be urged to stick to a long-term diet and activity plan for success.
Some people may experience nausea and vomiting the first few days following the procedure. This is due to your body adjusting to the new device. Taking your anti-nausea medication as directed can help alleviate these symptoms. We recommend staying hydrated by drinking clear liquids until your stomach adjusts to the balloon. Then, you can advance to more variety of soft foods like yogurt and smoothies.
The Day of the Procedure
When you arrive at the surgery center, nurses will help you transfer to a bed. Please inform the nurses if you have back problems or difficulty lying on your back so that they can assist you in finding a comfortable position to rest during your surgery.
Once in pre-op, you will meet with the surgeon and anesthesiologist to verify some information and discuss the procedure with them. They will also review your medical history and determine if you have any conditions that would make this procedure not an option for you. Examples include a hiatal hernia, previous gastric surgeries, severe liver disease, coagulopathies, and pregnancy.
During the non-surgical, endoscopic procedure, you will be lightly sedated, and your doctor will advance a thin tube (catheter) loaded with the Orbera balloon through the esophagus into the stomach. The balloon is then filled with a sterile saline solution to about the size of a grapefruit. After it is filled, the balloon will remain in your stomach for six months. You will work with your support team, including a nutritionist, therapist, and physical trainer, to reinforce long-term lifestyle changes during this time.
Some patients may experience nausea and vomiting while the balloon is in place. A clear liquid diet of water, sugar-free popsicles, Crystal Light, and strained clear broth is recommended to combat this. The use of anti-nausea medications such as Zofran can help alleviate symptoms.
Post-Procedure Care
The first few days after the procedure, you can only consume clear liquids such as water, juices, sugar-free popsicles, crystal light, strained broth, and other non-acidic fluids. This liquid diet generally continues until the start of the second week, and then you can advance to a soft food diet if your doctor feels that you can tolerate such foods.
Being as hydrated as possible after the Orbera balloon placement is important because it will likely take six hours to void your urine. As a result, you must schedule your bathroom trips at this time. You may need to empty a different number of fluids, however, on the first day after surgery, the typical patient may anticipate between 2,000 and 3,000 mL.
During the six months that you keep your Orbera gastric balloon in place, it will be important to work with your weight loss specialists to develop the new eating habits and lifestyle to help ensure the permanent weight loss you have achieved. This will include regular face-to-face meetings with your nutritionist, fitness trainer, and psychologist/psychiatrist. You must also continue to take your acid reflux and anti-nausea medications. If you do not, you could develop a peptic ulcer or hole (perforation) in your stomach wall, requiring medical attention.
