Prof. Dr. Taner YİĞİT
General Surgeon
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Gastric balloon application is a procedure in which a silicone balloon is placed in your stomach non-surgically. Since the material used in the production of the balloon is silicone, it does not harm your stomach tissue.
The basis of weight loss with the gastric balloon is the reduction of your stomach volume. Specifically, your stomach volume is approximately 1000cc. The balloon placed in your stomach is inflated with an average of 500-650cc of normal saline solution containing a blue dye called methylene blue. Thus, your stomach volume is reduced to approximately 350-500cc (1000 – 650 = 350cc). This causes you to eat less and stay full between meals.
While gastric balloons help you eat less and lose weight, they also allow you to adjust your eating pattern, learn what it means to eat little and live that way, and realize that you can live by eating little during the time the balloon remains in your stomach.
For 2-3 days following the gastric balloon application, you will experience nausea, vomiting, and occasional cramping pain, which will gradually decrease over time and disappear after your stomach adjusts to the balloon. Medication is planned to minimize these complaints after the procedure.
There are two types of gastric balloons: those that stay in your stomach for a short duration and those that stay for a long duration. The differences between these two balloon options are as follows:
The short-duration gastric balloon stays in your stomach for an average of 6 months, while the long-duration gastric balloon stays for an average of 12 months.
Short-duration gastric balloons are inflated to the targeted volume after being placed in the stomach, and their volume cannot be changed again. The volume of long-duration gastric balloons can be changed by decreasing or increasing the amount of fluid inside through endoscopic procedures applied at different times after being placed in the stomach.
This way, if there is a significant decrease in food and liquid intake due to the balloon, the balloon volume can be decreased to correct it, or conversely, if there is excessive food and liquid intake despite the balloon, the balloon volume can be increased.
The long-duration gastric balloon, when inflated less than the targeted final volume during the initial procedure and then inflated to the target volume with a new endoscopy one month later, allows you to have a milder adaptation period with fewer balloon-related nausea and vomiting complaints.
The fact that the retention time in the stomach is twice as long for one balloon does not mean that the weight loss will also be doubled.
Gastric balloons alone allow you to lose an average of 10-12% of your total weight. This rate increases to 12-15% for long-duration balloons. If you pay attention to what you eat and drink and exercise (preferably a regular walk of 4-5 km in 1 hour) while the balloon is in your stomach, these rates can increase up to 15-18%.
Who is eligible for surgery?
As with obesity surgery, your Body Mass Index (BMI) is a frequently used value in evaluating your suitability for gastric balloon application. Your BMI value is obtained by dividing your weight in kilograms by your height in meters, and then dividing the resulting value again by your height in meters:
Basically, the gastric balloon procedure is applied to the following patient groups:
Patients with a BMI between 27 and 35 who do not meet the criteria for surgery.
Patients with a BMI of 50 and above who are planned for surgery but are expected to lose a certain amount of weight before the operation (pre-operative preparation phase).
Patients who meet the necessary criteria for surgery (BMI between 35 and 50) but whose surgery is risky due to a serious co-morbidity and who require a certain amount of weight loss.
BMI Calculation
What preparations are required before the procedure?
A good and complete patient evaluation before the procedure is a prerequisite for a safe gastric balloon application. The first step to be planned for this purpose is a detailed patient-doctor consultation. After this consultation, your doctor will have:
Obtained your physical data (height, weight, BMI, etc.),
Learned your expectations from the gastric balloon procedure,
Learned the physical and psychological damage caused by your obesity and metabolic disease,
Understood your weight-related co-morbidities,
Gained knowledge about the severity of your metabolic diseases,
Decided whether you can comply with certain rules and lifestyle changes that will be requested after the procedure,
Made a comment about your general health status and made a preliminary decision on whether you will be suitable for this procedure.
The next stage is to conduct a pre-procedure evaluation at the hospital. At this stage, a series of blood tests are performed, which help us comment on whether the anesthesia and the endoscopy procedure you will undergo during the endoscopy can be performed safely.
Our team will contact you shortly regarding your appointment details.
How is it done?
The gastric balloon insertion and removal procedure is usually performed in the hospital’s endoscopy unit with accompanying anesthesia. During this time, an anesthesiologist and a technician are part of the team, along with the performing doctor. In some exceptional cases, this procedure can also be performed in the operating room under general anesthesia. After the anesthesia is administered, a classical endoscopy procedure is first performed on your stomach. During this time, it is checked whether there is any contraindication to the balloon application inside your stomach. If no pathology is found that would prevent the procedure, the gastric balloon insertion proceeds. A gastric balloon is advanced into your stomach via the mouth, filled with the targeted amount of fluid, and then left in your stomach. After this process, a control endoscopy is performed once more to check for any problems during the procedure. If it is decided that there is no problem during this control endoscopy, the procedure is terminated.
What preparations are required before coming to the hospital?
Since the procedure is an intervention performed on the digestive system:
Generally, starting to consume liquid food 1 day before the procedure is essential for a safe endoscopy procedure, as your stomach must be empty during the procedure.
If you are using blood-thinning medications, you must warn your doctor about this and give your doctor time to stop these medications and start alternative ones instead.
It is safe to continue using the routine medications you must take, except for blood thinners, until the night of the procedure. Blood pressure medication and heart medication can be taken on the morning of the procedure with a small amount of water, at least 2 hours before the procedure, with your doctor’s knowledge.
Your doctor will decide whether you should take your diabetes medications the night before the procedure, depending on the preparation planned for you. Generally, we restrict the use of these medications to prevent a sudden drop in your blood sugar, as you will eat little the night before the procedure and fast the next morning.
You should generally stop all solid or liquid food intake around 10-11 PM the night before the procedure, and you should be ready with at least 6 hours of fasting on the morning of the procedure.
How long will I stay in the hospital?
You are not required to stay in the hospital after the gastric balloon procedure. You should be at the hospital 1-2 hours before the procedure, and after the procedure, you can rest for about 1 hour, leave the hospital, and go home.
What will happen after the procedure? When you leave the hospital after the gastric balloon procedure, anti-nausea, anti-spasm, and stomach protection medication will be planned for you. Using the anti-nausea and anti-spasm medications for the first 4-5 days after the procedure will help you have a comfortable adaptation period. You should continue to use some of your stomach protective medications for one week, and others throughout the period the gastric balloon remains in your stomach. Your doctor will inform you in detail about your medication treatment. Starting from the meal following the balloon insertion, a liquid food-based diet plan is followed for 2-3 days, and then normal food is consumed.
When can I start my normal life? You can generally resume your normal life after a 2-3 day adaptation period following the gastric balloon procedure. During this period, called the adaptation period, which is characterized by nausea, vomiting, and cramping pain, you may be partially away from your work and duties.
What will my control and follow-up process be like?
After the balloon is placed in your stomach, there is a transition to a normal diet following a short-term liquid-based diet program, and your check-ups are done monthly through mutual consultation.
Our team will contact you shortly regarding your appointment details.