Utilization of the Intragastric Balloon (bib) in Pre-operative Preparation for Super Obese Patients with High Surgical Risk Comparing with Two Steps Surgery.

Background: Super obese patients show a high surgical risk (major complications in 30% and mortality rate of 5-12%). The present study evaluates the use of BIB as a preoperative procedure aiming an initial weight loss and reduction of surgical risk.

Methods: From November 2000 to February 2006, 66 super obese patients (mean BMI= 60.3 ± 10.1 kg/m²) were treated with the BIB for at least four months before surgical treatment: 45 male (BMI= 58.4 ± 8.0) and 11 female patients (BMI= 62.3 ± 10.7). They showed associated diseases, including systemic arterial hypertension (27 cases), diabetes mellitus (10 cases), sleep apnea (20 cases), hypercholesterolemy (10 cases) and osteoarthrosis (16 cases).

Results: Patients showed mean percent excess weight loss (%EWL) of 23.4 ± 11.0%, mean percent total weight loss (%TWL) of 13.6 ± 6.5%, and mean BMI reduction of 8.4 ± 4.9 Kg/m². Around 80% of patients showed good results with 27% EWL with improvement in hypertension, diabetes mellitus and sleep apnea. Surgical risk was reduced from ASA III-IV (before the BIB) to ASA II (after BIB). All these patients were submitted to bariatric surgery (GB 41%, LAGB 33% or SGBPD 26%).There was no mortality and only four minor complications (wound infection- 7.5 %).

Conclusions: Our results showed that the intragastric balloon is an effective technique in order to prepare super obese patients in preoperative time (79%), reducing their major complications and mortality. Effective non-surgical technique in pre-op time for patients BMI>50. Change surgical risk ASA III – IV to ASA II (79%). No mortality and minimal risk of major complications. Reduce 79% the indications of two stage surgery. Low risk and lower cost than two stage surgery.

Session: Podium Presentation

Program Number: S089

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