Abstract
Background and aim Intragastric balloon placement is established as a safe, relatively low-cost and
well-tolerated minimally invasive procedure for weight loss, giving encouraging results
under the strict prerequisite that the obese patient will enroll in a medically supervised
weight loss program. This retrospective study reviews already published cases of severe
visceral complications for the purpose of assigning responsibility to the device,
the patient, or the doctor.
Methods We reviewed PubMed and Scopus archived publications describing intragastric balloon
(BIB/Orbera)-related severe visceral complications, i. e. perforations and obstructions.
Results Twenty-two cases of gastric perforation, two cases of esophageal perforation and
10 cases of bowel obstruction were found. For the gastric perforation the endoscopist
was responsible in nine cases, the patient in four, and the balloon itself in nine.
For the two cases of esophageal perforation, the endoscopists were responsible, while
for the 12 cases of bowel obstruction, the patient was responsible for seven and the
device for the other five cases.
Conclusion BIB/Orbera balloon insertion remains a safe procedure, with a minimum of complications
related to hollow viscera. Mandatory education and accreditation of physicians dealing
with bariatric endoscopy and strict supervision of the obese individuals, while living
with the balloon, will eliminate such complications.
