Spanish Intragastric Balloon Consensus Statement (SIBC): practical guidelines based on experience of over 20 000 cases

• Eduardo Espinet Coll ^[1] ; Andrés J. del Pozo García ^[5] ; Román Turró Arau ^[6] ; Javier Nebreda Durán ^[7] ; Xavier Cortés Rizo ^[2] ; Andrés Serrano Jiménez ^[8] ; Miguel Ángel Escartí Usó ^[9] ; María Muñoz Tornero ^[10] ; David Carral Martínez ^[3] ; Jaime Bernabéu López ^[11] ; Cristian Sierra Bernal ^[4] ; David Martínez-Ares ^[12] ; Jesús Espinel Díez ^[13] ; Carlos Marra-López Valenciano ^[14] ; Javier Sola Vera ^[15] ; Laura Sanchis Artero ^[16] ; José Luis Domínguez Jiménez ^[17] ; Ramiro Carreño Macián ^[18] ; José Francisco Juanmartiñena Fernández ^[19] ; Arnulfo Fernández Zulueta ^[20] ; Claudia Consiglieri Alvarado ^[7] ; Eduardo Grecco ^[21] ; Lyz Bezerra Silva ^[21] ; Manoel Galvao Neto ^[21]
  1. [1] Institut Universitari Dexeus

     Institut Universitari Dexeus

     Barcelona, España

     
  2. [2] Hospital de Sagunto

     Hospital de Sagunto

     Sagunto/Sagunt, España

     
  3. [3] Hospital San Rafael

     Hospital San Rafael

     Barcelona, España

     
  4. [4] Hospital La Zarzuela

     Hospital La Zarzuela

     Madrid, España

     
  5. [5] Hospital Viamed Santa Elena. Madrid, Spain
  6. [6] Hospital Teknon. Barcelona, Spain
  7. [7] Clínica Diagonal. Barcelona, Spain
  8. [8] Hospital HLA La Vega. Murcia, Spain
  9. [9] Clínicas Intraobes. Valencia, Spain
  10. [10] Hospital Viamed San José. Murcia, Spain
  11. [11] Hospital HLA Santa Isabel. Sevilla, Spain
  12. [12] Hospital QuirónSalud. A Coruña
  13. [13] Hospital Universitario de León. León, Spain
  14. [14] Hospital Vithas Málaga. Málaga, Spain
  15. [15] Hospital IIMED. Elche, Alicante. Spain
  16. [16] Hospital Casa Salud. Valencia, Spain
  17. [17] Hospital Cruz Roja de Córdoba. Córdoba, Spain
  18. [18] Hospital QuirónSalud. Vitoria, Spain
  19. [19] Centro de Endoscopia Avanzada CEA-Navarra. Pamplona, Spain
  20. [20] Clínica del Remei. Barcelona, Spain
  21. [21] Brazilian Intragastric Balloon Consensus (BIBC) Group. Brazil

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 115, Nº. 1, 2023, págs. 22-34
• Idioma: inglés
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• Resumen

  • Background: intragastric balloons (IGBs) are a minimally invasive, increasingly popular option for obesity treatment. However, there is only one worldwide guideline standardizing the technical aspects of the procedure (BIBC, SOARD 2018). Objectives: to construct a practical guideline for IGB usage by reproducing and expanding the BIBC survey among the Spanish Bariatric Endoscopy Group (GETTEMO). Methods: a 140-question survey was submitted to all GETTEMO members. Twenty-one Spanish experienced endoscopists in IGBs answered back. Eight topics on patient selection, indications/contraindications, technique, multidisciplinary follow-up, results, safety, and financial/legal aspects were discussed. Consensus was defined as consensus ≥ 70 %. Results: overall data included 20 680 IGBs including 12 different models. Mean age was 42.0 years-old, 79.9 % were women, and the mean preoperative body mass index (BMI) was 34.05 kg/m². Indication in BMI > 25 kg/m², 10 absolute contraindications, and nutritional and medication measures at follow-up were settled. A mean %TBWL (total body weight loss) of 17.66 % ± 2.5 % was observed. Early removal rate due to intolerance was 3.62 %. Adverse event rate was 0.70 % and 6.37 % for major and minor complications with consensual management. A single case of mortality occurred. IGBs were placed in private health, prior contract, and with full and single payment at the beginning. Seven lawsuits (0.034 %) were received, all ran through civil proceeding, and with favorable final resolution. Conclusions: this consensus based on more than 20 000 cases represents practical recommendations to perform IGB procedures. This experience shows that the device leads to satisfactory weight loss with a low rate of adverse events. Most results are reproducible compared to those obtained by the BIBC.