E0610 - Global Adoption and Practice Patterns in Placing Intragastric Balloons

Kirtan Chauhan, MD¹, Ramzi Mulki, MD², Ahmad Bazarbashi, MD³, Diogo De Moura, MD, MSC, PhD⁴, Janese Laster, MD⁵, Vivek Kumbhari, MD, PhD⁶, Majidah Bukhari, MD⁷, Marvin Ryou, MD⁸, Christopher Thompson, MD, MSc, FACG⁸, Violeta Popov, MD, PhD, FACG^9
1Baylor College of Medicine, Houston, TX; ²University of Alabama at Birmingham, Birmingham, AL; ³Washington University School of Medicine, St. Louis, MO; ⁴The Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Sao Paulo, Brazil; ⁵Gut Theory Total Digestive Care, Washington, DC; ⁶Mayo Clinic Florida, Jacksonville, FL; ⁷American Hospital Dubai, Dubai, Dubai, United Arab Emirates; ⁸Brigham and Women's Hospital, Boston, MA; ⁹NYU Langone Health, New York, NY

Introduction: Intragastric balloons (IGB) have been used for over 30 years to treat obesity and have been approved in the US since 2015. Our objective was to globally survey IGB placement and management patterns.

Methods: A survey evaluating bariatric endoscopy (BE) practice patterns was distributed online via a digital platform to practitioners, participants in virtual international seminars in BE and in-person at the annual Association for Bariatric Endoscopy and Flexible Endoscopic Surgery meetings. The survey consisted of three parts. 1- physician demographics (practicing specialty, type and location of practice), 2- types of bariatric procedures offered 3- practice patterns for IGB placement/removal. The main comparisons were among geographic areas (Western, Middle East and Asia, South America), private vs. academic, and surgical vs. gastroenterology practice, using Pearson chi-square test, with p< 0.05 considered significant.

Results: In total, 110 participants responded to the survey. 79 (73.8%) were gastroenterologists, 25 (23.3%) were surgeons, and 3 (2.6%) participants were obesity medicine specialists. 62.8% were practicing in academic centers and performing procedures in ambulatory surgical center(ASC) settings (50%) (table 1). Orbera (Apollo Endosurgery; Austin, TX, USA)was the most common IGB placed in South America and Western countries, while Spatz (Spatz FGIA; Great Neck, NY, USA); was more commonly placed in the Middle East/Asia (figure 1). Gastroenterologists were more likely to place and remove IGB under monitored anesthesia care while surgeons were more likely to use general anesthesia with endotracheal intubation (52% vs 25% and 17.9% vs 1 %, p=0.0013; respectively). Private practitioners were more likely to use conscious sedation and start a liquid diet sooner (1 week) compared to those in academic centers, 60% vs 40%, p=0.03 & 56% vs 40% p 0.0041, respectively. Providers in the South America and Western countries were more likely to use ET for placement/removal compared to those in the Middle East/Asia.

Discussion: Based on this global survey, most IGB procedures are performed by gastroenterologists practicing in academic centers. Variation exists in the type of anesthesia and timing of diet initiation following IGB placement, with no significant difference in adverse events. Larger survey/registries and data are needed to inform best practice recommendations.




Disclosures:


Kirtan Chauhan, MD¹, Ramzi Mulki, MD², Ahmad Bazarbashi, MD³, Diogo De Moura, MD, MSC, PhD⁴, Janese Laster, MD⁵, Vivek Kumbhari, MD, PhD⁶, Majidah Bukhari, MD⁷, Marvin Ryou, MD⁸, Christopher Thompson, MD, MSc, FACG⁸, Violeta Popov, MD, PhD, FACG⁹. E0610 - Global Adoption and Practice Patterns in Placing Intragastric Balloons, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.