Bariatric Endoscopy-INTRAGASTRIC BALLOON REMOVAL: MANY SOLUTIONS IN ONE CASE

Video Transcription

Intragastric balloon removal, many solutions in one case. This is a case of a 70 years old female who placed an intragastric balloon a year ago.  She had a total weight loss of 20% and the patient had no symptoms. The aim of this video is to show you multiple techniques applied in one difficult case of balloon removal.  The first attempt, we used balloon removal forceps. Now we see the balloon impaction in antrum, that is probably an occasional position.  Now we make the puncture with a big needle and aspirate its content.  Now we make the mineral oil installation in esophagus to facilitate the balloon removal. This is a special forceps.  Now we grab the balloon and pull it out through the cardia and esophagus.  Second attempt with a big foreign body forceps. Now we are in esophagus grabbing the balloon with the big foreign body forceps.  The third attempt with a big foreign body forceps with the help of a snare. We position the snare outside the scope.  Now in the stomach we grab the balloon with the forceps, traction it. And now we open the snare and position it outside the foreign body forceps.  And use it to help the apprehension of the balloon.  Now in the fourth attempt we apprehend the inside valve with a snare. Now we enter the scope inside the balloon and find the inner valve, grab it with the snare.  You have to pay attention to grab it in the distal point. In this way we prevent lesions in removal of the balloon.  Divert the balloon carefully, be careful with the cardia and esophagus and also the cricopharyngeal region. The balloon was finally removed.  We make an endoscopic revision, paying attention to the upper and lower sphincters. And we have to make a new flex vision to see right the cardia. Thank you.  Here is the new flex vision.

Video Summary

This video showcases the removal of an intragastric balloon in a difficult case. The patient, a 70-year-old female, had a successful weight loss of 20% with no symptoms. Multiple techniques were used in the removal process. Initially, balloon removal forceps were used, followed by puncturing and aspirating the balloon's contents. Mineral oil was then inserted to aid in removal. Special forceps were utilized to grab and pull the balloon out through the cardia and esophagus. A snare was also used in subsequent attempts to grab and remove the balloon. The procedure concluded with an endoscopic revision and new flex vision to ensure proper examination.

Asset Subtitle

Honorable Mention

Keywords

intragastric balloon removal

difficult case

weight loss

balloon removal forceps

endoscopic revision