Transcription:

Bill Klaproth (Host): If you need to lose weight but aren't ready for a surgical bariatric procedure, the reshape balloon may be an option for you. Here to explain the reshape balloon is Dr. Basil Yurcisin. He is a bariatric and general surgeon and a partner at Garden State Bariatrics and Wellness Center. Dr. Yurcisin, thank you for your time. So what is the reshape balloon?

Dr. Basil Yurcisin, MD (Guest): Basically it's exactly what it says. It's a balloon that is placed endoscopically or with an endoscope into the stomach, and it takes up space so you can't eat as much, and it helps you lose weight. It helps you reshape your body.

Bill: So is it one big balloon? Or two balloons? How does it work?

Dr. Yurcisin: So yeah, it's two balloons that are anchored together, tethered together kind of like a dumbbell appearance, and essentially they're filled with saline and they're placed in the stomach, as I mentioned a moment ago, endoscopically. They're kept in the stomach for about six months.

Bill: So endoscopically you place the two balloons in the stomach, so then it makes you feel fuller quicker so you stop eating. Is that right?

Dr. Yurcisin: Yeah, that's the idea. The idea is that you have space occupying lesion in your stomach that takes up some of the space that food used to take up when you eat, and you're not as able to take in as many calories.

Bill: So this is a two-prong approach then. Balloons go in, and then diet retraining and counseling?

Dr. Yurcisin: Well actually what we try to do, is we try to have at least one counseling nutrition session prior to the balloons being placed, and then for the next one year after the balloons are placed, you have nutritional counseling. Now the balloons only stay in for six months, so six months with the balloon in, six months with the balloon out, and that's all part of the same program to help patients not only lose the weight while the balloons are in, but to maintain a healthy lifestyle, maintain a proper diet after the balloons are out.

Bill: Okay so the balloons are removed after six months, but then does the person risk having the weight come back? Or after the weight is off, through the diet retraining and coaching, the weight will generally stay off?

Dr. Yurcisin: That's the idea, that's the plan. Essentially the hardest thing a human being can do is try to change a habit, and whatever habit got our patients to the point where they're considering weight loss interventions, those habits need to be changed. And so our hope is that with the year-long nutritional counseling, you get as kind of best a shot at that as you can get.

Bill: Well that makes sense. So Dr. Yurcisin, who is a good candidate for the reshape balloon?

Dr. Yurcisin: So in general, anybody who has not had previous surgery on their stomachs before. So sort of since you can't do a balloon in somebody who's already had a previous bariatric surgery, something like a gastric bypass or a sleeve, or some other operation on their stomach- the organ their stomach. Somebody who's mildly overweight, somewhere in the range of forty to fifty pounds overweight is usually a pretty good candidate. And that would be somebody who doesn't quite qualify for bariatric surgery in the larger scheme of things. Also a person that may be a good candidate for a balloon is somebody who doesn't want to have bariatric surgery and wants to try to do it in a less evasive way.

Bill: So would this be a good first step then for people to try first?

Dr. Yurcisin: It's a possible first step for some people. Kind of the problem with it is the fact that it's not really covered by insurance at this time. So it can be prohibitive in the sense of the cost for all people to look at it as a first step, but it is an option for patients who are looking to lose weight that can finance the balloon placement.

Bill: Dr. Yurcisin, you said that this procedure is best for people that are mildly overweight, forty to fifty pounds, so how much can a person expect to lose over the six month period the balloons are in?

Dr. Yurcisin: Well the original studies, the average weight loss was right around thirty pounds, but we definitely have situations where patients lose more. So the average would be around thirty pounds, but you could fall on either side of that average depending on how well or not well you follow the rules, and the other rules are diet and exercise.

Bill: So how new of a procedure is this?

Dr. Yurcisin: It's been on the market for some time now, a couple years, and it was being done in trials prior to that, and there were some older iterations of the balloon back in the eighties. So it's not entirely a newfangled thing, but the current- the way it's currently constructed, the three balloons that are on the market currently, they've been around for the last two years or so.

Bill: Are there any risk factors involved with these balloons?

Dr. Yurcisin: Yeah, there are a couple risks. A couple of kind of more extreme ones are the balloons over-inflating on their own, the balloons causing pancreatitis. The balloons can actually potentially erode through the stomach because we're putting a foreign body into the stomach so it can act like foreign bodies do and cause some problems there. The balloons could deflate or rupture and migrate downstream and cause intestinal blockage. But the more common things are nausea and heartburn and maybe some ulceration of the stomach. All of those things we can usually treat with medications rather than having to remove the balloons.

Bill: You mentioned insurance doesn't cover this, but as far as cost is concerned compared to a surgical bariatric procedure, I would imagine this is more cost-efficient.

Dr. Yurcisin: It depends on if you have insurance paying for your procedure or not, so I guess it depends on the way you're looking at it. But overall, you're right, the cost of the balloon placement and removal and the nutritional counseling is much less than the cost of the surgery, or what is billed for the surgery from the hospital's standpoint, the anesthesiologist's standpoint, the surgeon's standpoint. So yeah there is a bit of a cost savings there.

Bill: This just seems like a great option for someone that needs to lose thirty pounds but are just having trouble getting it off.

Dr. Yurcisin: It is a great option. It's a very efficient option as well, whereas previous dieting may be met with not as robust of an outcome. The balloon has a lot more of a kind of predetermined- it's going to do well in general for the patient.

Bill: So this is done as an out-patient procedure. Can you tell me what the recovery is like?

Dr. Yurcisin: So the placement of the balloon takes fifteen or twenty minutes. It's done under a general anesthesia with an endoscope, so we put a scope down the throat into the stomach, we deploy the balloons, and then as you mentioned earlier, the device that is used to deploy is removed, the balloons are left behind, they're full of saline. You go to the recovery room and usually within the hour you're able to leave. Some of the recovery items, like I mentioned a moment ago, heartburn and nausea can sometimes be the things that are the biggest complaints in the beginning, but that's usually self-limited to the first couple days after the procedure and then you feel pretty normal.

Bill: Just amazing, that's wonderful. Any last thoughts on the reshape balloon, Dr. Yurcisin, that someone should know about?

Dr. Yurcisin: Basically just the fact that it's definitely an option when surgery is not an option.

Bill: Well Dr. Yurcisin, thank you so much for your time. For more information about the reshape balloon or any other bariatric surgery procedure, please visit the Garden State Bariatrics and Wellness Center website at www.GSBWC.com. That's www.GSBWC.com. This is Winning Through Losing, a weight loss surgery podcast with Garden State Bariatrics. I'm Bill Klaproth, thanks for listening.