Intragastric Balloon

There are a large number of people who want to lose just 10 to 15Kg. They are not candidates for surgery and they have run through the gauntlet of diets, exercise programs and a variety pills. For this group the intragastric balloon is an attractive option.

We inserted the first balloons in 2001 in Singapore and subsequently did the first insertions of the balloon in Japan and Indonesia soon after. The device has its fans and its detractors. On the plus side, the procedure is endoscopic and non-surgical. Insertion is done under sedation and takes just 5 to 10 minutes. It is a day procedure in most practices. It is relatively safe compared to other bariatric procedures.

The device acts by two mechanisms. Firstly it occupies space in the stomach and it's weight also adds to early satiety. Filled with saline it weighs about 500 to 700grams. It is like having 2 or 3 hamburgers in the stomach at all times. The patient is unable to take his usual volume of food. Secondly it slows down gastric emptying so that whatever food eaten takes a long time to leave the stomach. Stomacg peristalsis is markedely reduced.

The disadvantages of the device are the often less than pleasant adaptation period. This can last from a few days to a week or more. The patient has cramps, nausea and vomitting much like the morning sickness of a pregnant woman. After the adaptation, the symptoms usually subside and the patient can eat somewhat normally though a lesser amount.

The second disadvantage is that the device has to be removed after 6 months. After this the patient is left to his own devices to maintain the lost weight. Usually one hopes the patient has learnt to live a healthier lifestyle by then. The device can however be re-inserted in 2 or 3 months after removal. Some patients are using the method of sequential balloons.

The average weight loss is between 12 to 14Kg during the 6 months period. The device is then removed.

This method is popular with many overweight young and middle aged ladies both in Singapore and in Indoenesia. The patient's usually want to keep the fact that they have a balloon confidential as they don't want their husbands to know or their friends to realise that they lost weight by any other means than their own discipline.

One of the pleasant side benefits is that patients who have diabetes, hypertension or high cholesterol often improve on the device.

Kazaks come to Singapore

Most people know about Kazakstan only through the Borat movie. To be fair the movie made them look much more primitive than they actually are. Kazakstan is an oil producer and developing rapidly. The Kazaks however do eat Horse meat and drink horse milk. Their diet is rich in meat.

These two gentleman came to Singapore for bariatric and metabolic surgery after reading this blog. The younger gentleman is BMI 42 and had a laparoscopic sleeve gastrectomy. This picture shows him 3 days post-op. His father had Type II Diabetes and was on two types of medication plus insulin.
He is 2 days post-op in this picture. His blood sugar is normal, 6 mmole/dl with no medication or insulin at all. He is drinking freely.

Today both father and son had tea and hot chocolate at a French cafe on Scotts Road. The father is 3rd day post op and the son is 4th day post op. They return to Kazakstan in 2 days time.

Diabetes is no longer an incurable cases for most people.