D0612 - The “Scissors Technique:” An Effective Alternative for Gastric Balloon Removal

Richard A. Blosser, MD¹, Andrew C. Van Dam, ², Neda H. Noori, MS¹, Nichole E. Teifer, ^1
1The Gastroenterology Center of Virginia, Endoscopic Wellness Center of America, Reston, VA; ²The Gastroenterology Center of Virginia, Reston, VA

Introduction: Using the currently available Apollo Endosurgery Equipment, we have created a new method of gastric balloon removal termed the “Scissors Technique.” We have evaluated the effectiveness of this new technique as compared to the current needle withdrawal method suggested by Apollo Endosurgery, and we deem the “Scissors Technique” a safe and effective alternative.

Methods: The patient's head is elevated at a 45-degree angle prior to performing a routine EGD. Confirmation of no retained food debris in the lumen of the stomach is required to proceed with balloon removal. Endoscopic scissors are then inserted into the scope channel and into the gastric lumen. The sharp, rigid end of the scissors, in an open-mouthed fashion, creates an incision on the surface of the balloon, allowing saline to flow out of the balloon. The “Scissors Technique” extends the opening > 2 cm. Once a large enough incision has been made, the scissors are removed from the scope. The scope is then inserted into the lumen of the balloon to check for the valve and to aspirate any residual fluid. Once the balloon is fully decompressed, using the viper, the grasping device, the balloon is grasped on the opposite end of the outlet created by the “Scissors Technique”, allowing the esophageal sphincter to squeeze out the rest of the saline as the balloon is removed. After the balloon is fully removed, a routine EGD is performed to ensure the airway, esophagus and stomach are free of residual fluid and injury. The entire removal should take no more than ten minutes.

Results: From June 2019 to May 31, 2022, approximately 254 patients had their gastric balloon removed using the Scissors Technique

Indications: gastric balloon removal method

Endoscopic Scissors: LOT: 00470, Maximum Insertion Diameter: 2.6 mm, Minimum Channel Size: 2.8 mm

Viper: Grose/Size/Dimension: Diam. CH 7- Lg 180cm, LOT: 12457, REF: SN3980718

Upper Endoscope - Olympus GIF H180

Age range: 18 yo - 60 yo

BMI range: 28 - 45

Time range: 5-9 min x̅ 7 min

Discharge criteria: no delay in discharge, patients may leave facility same day of removal

Complications: None (0) - aspirations, perforations, bleeding, delayed discharge, dysphasia

Discussion: The Scissors Technique performed well in all aspects of the method described.The technique should be considered as a promising and innovative alternative approach to the current Apollo method, as it is deemed to be both quicker and safer, and thus, should be adopted for gastric balloon removal.


Disclosures:


Richard A. Blosser, MD¹, Andrew C. Van Dam, ², Neda H. Noori, MS¹, Nichole E. Teifer, ¹. D0612 - The “Scissors Technique:” An Effective Alternative for Gastric Balloon Removal, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.