title: The intra-gastric balloon for pre-operative weight loss in bariatric surgery: is it worthwhile?
abstract: BACKGROUND
  Super-obese patients in NHS Lothian during 2009-2010 were offered the intragastric balloon to assist with weight loss prior to definitive bariatric surgery along with participation in a structured weight management programme. Those who declined balloon placement continued to receive weight management alone (WM). The aim of this study was to compare the effectiveness of the structured weight management programme with and without the addition of the intragastric balloon.
  
  
  METHODS
  Patients referred to the NHS Lothian Bariatric Service in 2009 with BMI > 55 kg/m(2) or weight > 200 kg and assessed as otherwise eligible for bariatric surgery were offered structured weight management with or without placement of an intragastric balloon with the aim of achieving a target of 10 % excess weight loss (EWL) over 6 months.
  
  
  RESULTS
  Twenty-eight patients were recruited. Fifteen opted for balloon placement and 13 declined. Three patients in the balloon group required early balloon removal due to intolerance and three dropped out of the WM group through non-attendance. Of those remaining, two in the balloon group and three in the WM group failed to achieve the 10 % EWL target. Overall, median %EWL was 17.1 % for the balloon group and 16.1 % for the WM group (p = 0.295, Mann-Witney U-test).
  
  
  CONCLUSIONS
  The additional use of intragastric balloon conferred no benefit over structured weight management alone in achieving pre-operative weight loss in a super-obese patient population. In the context of limited resources within NHS Lothian, the continued use of intragastric balloon in this way cannot be justified.
authors: NHS Lothian Bariatric Service, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK. mfleeman@nhs.net
authors: M F
authors: MF
authors: Leeman
authors: C
authors: C
authors: Ward
authors: M
authors: M
authors: Duxbury
authors: A C
authors: AC
authors: de Beaux
authors: B
authors: B
authors: Tulloh
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D020878:Device Removal / Q000379:methods*; D005260:Female; D015905:Gastric Balloon / Q000009:adverse effects / Q000191:economics; D015391:Gastroplasty / Q000191:economics / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000191:economics / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009767:Obesity, Morbid / Q000191:economics / Q000453:epidemiology / Q000601:surgery*; D011300:Preoperative Care / Q000191:economics; D012606:Scotland / Q000453:epidemiology; D016896:Treatment Outcome; D019564:Unnecessary Procedures / Q000191:economics; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000191:economics / Q000379:methods