Comparison of Efficacy of Intragastric Balloon Devices as Bridging Therapy Prior to Laparoscopic Sleeve Gastrectomy

Background: Bridge therapy before surgery is one of indications for intragastric balloon (IGB) implantation. We aim to compare the outcomes of Medsil (non-adjustable), Orbera365 (non-adjustable), and Spatz3 (adjustable) IGBs used as a bridge therapy before laparoscopic sleeve gastrectomy (LSG). Methods: The data of 148 patients with super-obesity (BMI > 50 kg/m²) who underwent IGB implantation as bridge treatment prior to LSG between July 2018 and December 2022 were analyzed. Patients were allocated according to device availability in consecutive procurement periods: Orbera365 (47 patients), Medsil (53 patients), and Spatz3 (48 patients). Weight loss (kg), BMI reduction, and percentage of excess weight loss (%EWL) were measured at 6 months. Results: Weight loss after 6 months was greatest in the Spatz3 group (mean 25 kg; median 24.64 kg; 19.46-33.04 kg) compared to the Medsil (mean 16 kg; median 16 kg; 11.7-33 kg) and Orbera365 (mean 14 kg; median 14.53 kg; 11.54-18.26 kg) groups. %EWL and %TWL were also greatest in the Spatz3 group (%EWL: 22.98%; %TWL: 14.0%) compared to the Medsil (%EWL: 15.06%; %TWL: 9.4%) and Orbera365 (%EWL: 13.71%; %TWL: 8.3%) groups. Conclusions: In super-obese patients undergoing a 6-month bridging therapy before LSG, an adjustable IGB with mid-term volume increase achieved greater short-term weight loss than non-adjustable devices. Implications for peri-operative outcomes require confirmation in prospective studies.