The balloon is introduced into the stomach through the mouth without the need for surgery. The physician conducts an initial examination of the stomach using an endoscopic camera. If no abnormalities are identified, the physician proceeds with placement of the balloon through the mouth, down the esophagus and into the stomach. The balloon is made of a soft and pliable silicone elastomer material and is inserted while in its smallest, deflated form. The passage of the deflated balloon is made easier with the help of anaesthetic applied topically to numb the throat area. Patients may receive medication to enhance sedation and reduce anxiety during the procedure. Patients do not require general anaesthesia or overnight hospitalization.

Once the balloon is inside the stomach, it is immediately filled with sterile saline through a small filling tube (catheter) attached to the balloon. Once filled, the physician removes the catheter by gently pulling on the external end. The balloon has a self-sealing valve, and at this point the balloon is floating freely in the stomach.

While the balloon is in the stomach the physician may prescribe a course of oral medication to reduce stomach acid. This may reduce the possibility of stomach irritation and damage to the balloon.

Placement times vary but it will usually take 20–30 minutes, after which the Toronto / Mississauga intra-gastric balloon patient will be monitored for 1–2 hours in the clinic and then may return home. Patients may experience some discomfort during the procedure but pain is not expected and therefore analgesic medication is not needed.

Advice after Gastric balloon system placement:

• Eat slowly and chew food thoroughly

• Divide food intake into small amounts and use small plates

• Stop eating if you feel acid reflux or heartburn

• Plan to have three meals a day

• Avoid snacking

• Drink at least one and a half litres of water every day

• Do not drink and eat at the same time. It can be useful to have a glass of water half an hour before each meal and one or two glasses after each meal. This will wash the balloon, which prevents unpleasant breath which can occur due to the stagnation of food around the balloon

• Avoid carbonated drinks. Strong tea, coffee and alcohol are also not advised

• Do not eat for two hours before going to bed

• Increase the amount of physical activity each day. For example, try to walk at least fifteen minutes each day