Background: Bridge therapy before surgery is one of indications for intragastric balloon (IGB) implantation. We aim to compare the outcomes of Medsil (non-adjustable), Orbera365 (non-adjustable), and Spatz3 (adjustable) IGBs used as a bridge therapy before laparoscopic sleeve gastrectomy (LSG). Methods: The data of 148 patients with super-obesity (BMI > 50 kg/m²) who underwent IGB implantation as bridge treatment prior to LSG between July 2018 and December 2022 were analyzed. Patients were allocated according to device availability in consecutive procurement periods: Orbera365 (47 patients), Medsil (53 patients), and Spatz3 (48 patients). Weight loss (kg), BMI reduction, and percentage of excess weight loss (%EWL) were measured at 6 months. Results: Weight loss after 6 months was greatest in the Spatz3 group (mean 25 kg; median 24.64 kg; 19.46–33.04 kg) compared to the Medsil (mean 16 kg; median 16 kg; 11.7–33 kg) and Orbera365 (mean 14 kg; median 14.53 kg; 11.54–18.26 kg) groups. %EWL and %TWL were also greatest in the Spatz3 group (%EWL: 22.98%; %TWL: 14.0%) compared to the Medsil (%EWL: 15.06%; %TWL: 9.4%) and Orbera365 (%EWL: 13.71%; %TWL: 8.3%) groups. Conclusions: In super-obese patients undergoing a 6-month bridging therapy before LSG, an adjustable IGB with mid-term volume increase achieved greater short-term weight loss than non-adjustable devices. Implications for peri-operative outcomes require confirmation in prospective studies.

Background Bridge therapy before surgery is one of indications for intragastric balloon (IGB) implantation. We aim to compare the outcomes of Medsil (non-adjustable), Orbera 365 (non-adjustable) and SPATZ3 (adjustable) IGB used as a bridge therapy before laparoscopic sleeve gastrectomy (LSG). Methods The data of 148 patients with severe obesity (BMI >=50 kg/m2) who underwent IGB implantation as bridge treatment prior to LSG between July 2018 and December 2022 was analysed. Patients were randomly assigned to 3 different IGBs: ORBERA 365 (47 patients), MEDSIL (53 patients), and SPATZ3 (48 patients). Weight loss (kg), BMI reduction and percentage of excess weight loss (%EWL) were measured at 6 months. Results Weight loss after 6 months was the best in the SPATZ3 group (mean 25 kg; median 24,64 kg; 19,46 – 33,04 kg) compared to Medsil (mean 16 kg; median 16 kg; 11,7 – 33 kg) and ORBERA365 (mean 14 kg; median 14,53 kg; 11,54 – 18,26). Weight loss after 6 months was highest in the SPATZ3 group (mean 25 kg) compared to Medsil (16 kg) and ORBERA365 (14 kg). %EWL and %TWL were also greatest in the SPATZ3 group (%EWL: 22.98%; %TWL: 14.0%) compared to Medsil (%EWL: 15.06%; %TWL: 9.4%) and ORBERA365 (%EWL: 13.71%; %TWL: 8.3%). Conclusion The bridge therapy before LSG with adjustable IGB after 6 months seems to be superior to non-adjustable devices.