New technique for endoscopic removal of intragastric balloon placed for treatment of morbid obesity.
BACKGROUND
Placement and removal of the intragastric balloon for obesity are performed endoscopically often under general anesthesia. We propose a safer and faster technique for endoscopic removal of the intragastric balloon using standard sedation.


METHODS
In 87 obese patients, we performed 3 removal techniques: 1) standard gastroscope and foreign body forceps, 2) standard gastroscope and retrieval snare, 3) double-channel gastroscope and foreign body forceps plus symmetrical "shark model" polypectomy snare. Balloon retrieval time, number of times the grasping devices lost the balloon, amount of antispasmodic drug, symptoms cumulative score and VAS score for discomfort were evaluated.


RESULTS
The technique by double-channel gastroscope and foreign body forceps plus symmetrical polypectomy shark retrieval snare showed a significantly lower balloon retrieval time, number of lost balloons, total number of ampoules used, symptoms cumulative score and VAS score compared to the other two techniques (Dunn's P<0.05). Number of lost balloons was positively associated with number of antispasmodic ampoules used, balloon retrieval time and VAS score.


CONCLUSIONS
Technique by double-channel gastroscope and foreign body forceps plus symmetrical polypectomy shark retrieval snare, allows balloon removal safely, quickly and easily, avoiding loss of the balloon, with good patient endurance.
Department of General, Geriatric, Oncological Surgery and Advanced Technologies Special Section of Surgical Digestive Endoscopy, School of Medicine, University Federico II of Naples, Italy. galloro.g@tin.it
Giuseppe
G
Galloro
Luigi
L
Sivero
Luca
L
Magno
Giorgio
G
Diamantis
Antonio
A
Pastore
Paris
P
Karagiannopulos
Maurizio
M
Inzirillo
Cesare
C
Formisano
Paola
P
Iovino
D000328:Adult; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D015905:Gastric Balloon; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000628:therapy*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors