Fast and safe placement of endogastric balloons
Fast and safe placement of endogastric balloonsA new system developed by Clínica Planas enables the fast and safe placement of endogastric balloons
The two main difficulties that endocopists face when inserting an endogastric balloon are that the balloon is not rigid enough and that its introduction into the oesophagus can not be controlled visually. As a result, it is occasionally accidentally introduced on the respiratory system instead of the oesophagus, particularly if the patient is very obese or has a short neck. The risk of hypoxia exists: if the balloon is inserted in the respiratory channel and we remove the endoscope suddenly, the balloon may be separated from the endoscope inside the respiratory channel, causing hypoxia. This can happen even at the hands of expert endoscopists. An anaesthetist will therefore intubate the patient and the balloon introduction is carried out in a surgical theatre so as to be able to react efficiently if such complications occur. Dr. Ramón Abad Belando, head of the Clínica P’s Digestive Endoscopy Unit, has developed a simple and efficient system, which allows doctors to place the endogastric balloon in the stomach quickly and safely, drastically reducing the possibility of insertion in the respiratory system. This system rules out the possibility of coughing, laringospasm and in the worst cases, hypoxia. In summary, the proven benefits of this new technique are:
1.- Safe introduction of the balloon from mouth to stomach, with no risk of it entering the respiratory tract.
2.- Fast introduction (average time from mouth to stomach - 4 seconds).
3.- Less endoscope presence, which is preferable for respiratory tracts.
4.- Minimal sedation time.
The patient first undergoes an initial gastroscopy to rule out any contraindication to balloon insertion. The endoscope is located in the normal manner, with direct vision, so as to avoid the possibility of it entering the respiratory tract.
Once the endoscope is located in the stomach and there are no contraindications to balloon insertion:
1.- A nitinol guide is inserted through the endoscope. The end of this guide is located in the duodenum.
2.-The endoscope is then removed and the guide remains in place, with one end in the stomach and the other outside the mouth.
3.- This guide is then used to insert a carrier with the endogastric balloon and its probe.
4.- Both the carrier and the balloon are pushed through the guide with no possibility of missing the stomach.
5.- Once the balloon is in the stomach, we fill it and ensure it is correctly positioned. The filling is controlled by endoscope.
6.- The endoscope is retracted.
7.- Once the balloon is filled, its probe, carrier and guide are all removed at the same time. 8.- The correct placement of the balloon is confirmed via a final endoscope. This technique is patented and is applicable to all endogastric balloons on the market. The introduction mechanism (probe, guide and carrier) should be incorporated with each balloon sold.