Are intra-gastric adjustable balloon system safe? A case series

INTRODUCTION: Intra-gastric balloons have been in use as an aide to weight loss. Since its introduction, it has evolved from air filled to saline filled intra-gastric balloons. The SPATZ-ABS is a new adjustable salinefilled balloon. PRESENTATION OF CASE: Three patients have presented to our hospital as emergencies due to complications arising from this balloon. Two of these patients required emergency laparotomy and resection of small bowel due to pressure necrosis effects of the anchoring device. One patient had migration of the device into the duodenum that was removed endoscopically. Of the 2 patients who underwent a laparotomy, one patient did not have any symptoms or signs that correlated with the intra-operative findings. DISCUSSION: The anchoring device meant to prevent the intra-gastric balloon from migrating distally has migrated in three patients. To our knowledge, there has been no reported incident of migration of this device. These serious complications pose a risk to patients having these balloons fitted. CONCLUSION: There is a need to study our experience with a larger population of patients who have had this device inserted. Its safety needs to be questioned and its design may need to be addressed. (c) 2013 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd.