Balloon removal
Removal was routinely planned for 360 days, but occurred with a minimum
of 270 and maximum of 390 days after balloon implantation. Removal was
preceded by a five day clear-fluid diet, in order to minimize the risk
of residual food entering the trachea. Deep intravenous anesthesia
without tracheal intubation was used, with the patient in a lateral
decubitus position. The presence of solid food waste in the stomach
resulted in the cancelation of the procedure and another was scheduled
with adequate preparation.
All the liquid content in the mucosal lake was aspirated. After
insertion of the gastroscope in the stomach, a needle-catheter was
inserted down the working channel of the gastroscope and introduced
inside the balloon after puncture. The needle was withdrawn with vacuum
applied to completly empty the balloon. Following intravenous
administration of scopolamine for relaxation of the lower esophageal
sphincter, the catheter was removed and the balloon was grasped with a
polypectomy snare on the base of the tail, and slowly extracted through
the esophagus. No cases of aspiration were observed during this
procedure. After balloon removal, a endoscopy was performed in order to
detect possible damage caused by the passage of balloon