Obesity Surgery

, Volume 29, Issue 4, pp 1445–1446 | Cite as

Modifying an Intragastric Balloon for the Treatment of Obesity: a Unique Approach

  • Leonardo Salles de Almeida
  • Ahmad Najdat Bazarbashi
  • Thiago Ferreira de Souza
  • Bruna Furia Buzetti Hourneaux de Moura
  • Diogo Turiani Hourneaux de MouraEmail author
Video Submission



The use of intragastric balloons (IGB) for the treatment of obesity has been increasing significantly, with data confirming its effectiveness with low complication rates. Adjustable balloons are not widely available for use in all countries, including the USA. In this video, we demonstrate a unique technique in which a conventional nonadjustable balloon is modified to an adjustable balloon to improve weight loss.


A 35-year-old woman with a BMI of 36.1 kg/m2 (84.4 kg) who had failed prior medical therapy for obesity presented for IGB placement. After discussion with the patient, including risks and benefits, a conventional IGB modified to a novel adjustable IGB was placed.


In this primary experience, we describe the use of a conventional IGB modified to an adjustable balloon. First, during balloon placement, an initial 500 ml of saline was instilled. At one-month follow-up, the patient only experienced 3.67%TBWL; thus, the balloon was adjusted with the addition of 160 ml of saline through the newly created modification catheter. At a 2-month follow-up, a second adjustment was performed with the addition of 180 ml, for a total of 840 ml. At 4 months, patient experienced 10% TBWL and decreased in BMI by 3.6 kg/m2. No adverse events were reported.


The transformation of a nonadjustable balloon into an adjustable balloon is feasible and effective in weight loss. This technique may be an alternative in cases where adjustable balloon is not available. Further studies are warranted to confirm the safety and efficacy of this novel device.


Obesity Weight loss Intragastric balloon Endoscopy Adjustable balloon Experimental 


Compliance with Ethical Standards

Conflict of Interest

Leonardo Salles de Almeida has a patent for the adjustable implant kit.

Thiago Ferreira de Souza is a consultant for Apollo Endosurgery.

All other authors have no conflict of interest.

Ethical Approval

Institutional Review Board of the Hospital approved the study. Informed consent was obtained from the participant included in the study.

Supplementary material

11695_2019_3771_MOESM1_ESM.mp4 (114.6 mb)
ESM 1 (MP4 117,300 kb)


  1. 1.
    Moura D, Oliveira J, De Moura EG, et al. Effectiveness of intragastric balloon for obesity: a systematic review and meta-analysis based on randomized control trials. Surg Obes Relat Dis. 2016;12(2):420–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Genco A, Dellepiane D, Baglio G, et al. Adjustable intragastric balloon vs non-adjustable intragastric balloon: case-control study on complications, tolerance, and efficacy. Obes Surg. 2013;23(7):953–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Leonardo Salles de Almeida
    • 1
  • Ahmad Najdat Bazarbashi
    • 2
  • Thiago Ferreira de Souza
    • 3
  • Bruna Furia Buzetti Hourneaux de Moura
    • 4
  • Diogo Turiani Hourneaux de Moura
    • 2
    • 3
    Email author
  1. 1.IMO – Instituto Mineiro de ObesidadeBelo HorizonteBrazil
  2. 2.Harvard Medical School, Division of Gastroenterology, Hepatology and EndoscopyBrigham and Women’s HospitalBostonUSA
  3. 3.Gastrointestinal Endoscopy UnitHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo – HC/FMUSPSão PauloBrazil
  4. 4.Hospital Municipal Dr. Moisés DeutschSão PauloBrazil

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