Balloon placement
Balloon insertion was performed after a diagnostic endoscopy to detect
pathologies that might contraindicate balloon placement, such as active
peptic ulcers, grade C-D esophagitis, large volume hiatal hernia,
esophageal / fundus varices, esophageal strictures and prior gastric
surgery.
The endoscopy procedure was performed under deep sedation without
endotracheal intubation, with continuous oxygen support with 5L/ min and
under anesthesiologist supervision. After the passage of the balloon,
correct positioning was checked endoscopically, with the balloon valve
positioned 2 cm below the cardia. The balloon inflation was under direct
vision with the endoscope in rear view position. The balloon was filled
with 3% saline solution and 10mL of 4% methylene blue. The balloon
volumes ranged from 600 to 700 mL.
After the filling, balloon valve was closed with a syringe vacuum and
the catheter disconnected by traction. Then the balloon was visually
inspected for possible deflation or valve malfunctions and to confirm
correct positioning in the gastric fundus. If leakage was detected,
prompt replacement of the defective balloon was conducted.