Stomach bubble
The stomach bubble is inserted into the stomach by way of a gastroscopy. Once positioned it is filled with liquid (500 – 600ml). This procedure can be performed in a short time as outpatient treatment. The operating principle is based on the interaction of stomach wall extension and the de facto reduction of stomach volume caused by the lying bubble. This is intended to cause a permanent feeling of satiety with subsequent reduction of meal sizes. After initial technical problems this method is currently rather widespread. However, because it is only temporarily deployable –the bubble has to be removed after 6 months- this method is not very relevant to the long-term treatment of morbid obese patients.
Complications possible with this procedure are the same as those for gastroscopy. During the first few days nausea occurs which is difficult to treat. This will abate rather quickly though. As treatment progresses the bubble may burst in a very low percentage of patients, and be evacuated by travelling through the small bowel and bowel where it is finally discarded with the patient’s stool in a natural way. On rare occasions it may cause a bowel occlusion and require emergency surgical removal. Aside from this, gastro-mucosal changes will occur for mechanical reasons, and in exceptional cases, caused by uncontrolled food intake, an overextension of the stomach may occur, even causing it to burst. However in general this method is comparatively free of complications. Indications to insert stomach bubbles are currently a controversial topic.
Because of it being rather uncomplicated, better materials, and a proven effect, the stomach bubble may be used in combination with a modern nutritional therapy which needs to be continued beyond the 6-month bubble treatment utilised in treating grade I and II adiposity (see also modern alimentary therapy). In morbid adiposity (BMI>40) this method is not suitable for long-term therapy. This method may be used for weight reduction before surgery in super-obese patients (BMI > 50), to lower the surgical risk. Use in high-risk patients not qualified for surgical therapy is currently under discussion, as well as application for testing of the success of stomach-restrictive procedures such as band insertions. However, final evaluation of the potential scope of applications for this method, especially concerning weight progress during years following the removal of the bubble, is not possible as not enough data is available. Only a few centres in Switzerland offer stomach bubble therapy. Swiss health insurance providers do not cover the costs of this procedure.