The ABCs of Orbera Intragastric Balloon: Indications and Contraindications

Endoscopically placed intragastric balloons are the least invasive type of weight loss procedure currently available. Orbera is a silicone balloon that is placed into the stomach through the mouth and filled with 400 to 700 mL of fluid, which expands it into a spherical shape. The balloon makes the stomach feel full and able to hold less food. It has to be combined with a diet and exercise program to maximize weight loss.

Typical results include weight loss of 20 to 35 pounds and improvement in medical problems such as diabetes and hypertension. After six months, the balloon is removed, the patient continues with the diet and exercise program, and often prescription medications that help with weight loss and weight loss maintenance.

Oregon Weight Loss Surgery LLC surgeons Dr. Emma Patterson and Dr. Avishai Meyer are now offering the Orbera balloon at Wilshire Surgery Center in Portland. Please contact us for more information.

For patients and providers, Dr. Patterson has created a simple “ABCs” guide to the indications and contraindications for the Orbera balloon, according to the Food and Drug Administration (FDA).

ABCs of ORBERA INDICATIONS

A. Age:

Patients who are 18 years old or older.

B. BMI:

Patients who have a Body Mass Index (BMI) between 30 and 40 kg/m2 in conjunction with long-term supervised diet and behavior modification program

C. Conditions:

Has tried more conservative weight reduction alternatives, such as supervised diet, exercise, and behavior modification programs.

ABCs of ORBERA CONTRAINDICATIONS

A. Anatomic:

1. Prior gastric or bariatric surgery
2. A large hiatal hernia of > 5cm hernia or ≤ 5 cm with associated severe or intractable gastro-esophageal reflux symptoms
3. Potential upper gastrointestinal bleeding conditions, such as esophageal or gastric varices, congenital or acquired intestinal telangiectasis, or other congenital anomalies of the gastrointestinal tract, such as atresias or stenoses
4. Gastric mass
5. Presence of more than one intragastric balloon at the same time
6. A structural abnormality in the esophagus or pharynx, such as a stricture or diverticulum that could impede passage of the delivery catheter and/or an endoscope.

B. Behavior

1. Patients unwilling to participate in an established medically supervised diet and behavior modification program, with routine medical follow-up
2. Patients who are unable or unwilling to take prescribed proton pump inhibitor medication for the duration of the device implant.
3. Patients receiving aspirin, anti-inflammatory agents, anticoagulants or other gastric irritants, not under medical supervision.

C. Conditions

1. Patients who are known to be pregnant, plan to become pregnant within 6 months, or are breast-feeding
2. Alcoholism or drug addiction
3. Any inflammatory disease of the gastrointestinal tract including esophagitis, gastric ulceration, duodenal ulceration, cancer or specific inflammation such as Crohn’s disease
4. Severe coagulopathy
5. Hepatic insufficiency or cirrhosis
6. Any other medical condition that would not permit elective endoscopy, such as poor general health or history and/or symptoms of severe renal, hepatic, cardiac, and/or pulmonary
   disease
7. Serious or uncontrolled psychiatric illness or disorder that could compromise patient understanding of, or compliance with, follow-up visits and removal of the device after 6 months
8. Achalasia, symptoms suggestive of delayed gastric emptying, or presence of any other severe motility disorder that that may pose a safety risk during removal of the device
9. Patients who are known to have or suspected to have an allergic reaction to materials contained in Orbera.