Comparison of Efficacy of Intragastric Balloon Devices as Bridging Therapy Prior to Laparoscopic Sleeve Gastrectomy

Background Bridge therapy before surgery is one of indications for intragastric balloon (IGB) implantation. We aim to compare the outcomes of Medsil (non-adjustable), Orbera 365 (non-adjustable) and SPATZ3 (adjustable) IGB used as a bridge therapy before laparoscopic sleeve gastrectomy (LSG). Methods The data of 148 patients with severe obesity (BMI >=50 kg/m2) who underwent IGB implantation as bridge treatment prior to LSG between July 2018 and December 2022 was analysed. Patients were randomly assigned to 3 different IGBs: ORBERA 365 (47 patients), MEDSIL (53 patients), and SPATZ3 (48 patients). Weight loss (kg), BMI reduction and percentage of excess weight loss (%EWL) were measured at 6 months. Results Weight loss after 6 months was the best in the SPATZ3 group (mean 25 kg; median 24,64 kg; 19,46 – 33,04 kg) compared to Medsil (mean 16 kg; median 16 kg; 11,7 – 33 kg) and ORBERA365 (mean 14 kg; median 14,53 kg; 11,54 – 18,26). Weight loss after 6 months was highest in the SPATZ3 group (mean 25 kg) compared to Medsil (16 kg) and ORBERA365 (14 kg). %EWL and %TWL were also greatest in the SPATZ3 group (%EWL: 22.98%; %TWL: 14.0%) compared to Medsil (%EWL: 15.06%; %TWL: 9.4%) and ORBERA365 (%EWL: 13.71%; %TWL: 8.3%). Conclusion The bridge therapy before LSG with adjustable IGB after 6 months seems to be superior to non-adjustable devices.