Safe removal of an Allurion swallowable intragastric balloon using an EUS aspiration needle at a non-specialist centre

Intragastric balloons (IGBs) are an increasingly popular management strategy for obesity. The Allurion IGB is a swallowable balloon that spontaneously degrades after residing in the stomach for 4 months. We describe a technique for safe retrieval of an Allurion IGB using endoscopic accessories available at hospitals without a dedicated bariatric service. Nausea and pain are often encountered following IGB insertion. Infrequent but serious adverse events have been noted by NICE. As it does not normally require endoscopic removal, a specific endoscopic kit has not been designed for the Allurion IGB. Devices designed for other types of IGBs have previously been used to extract the Allurion balloon. We achieved a similar outcome using an endoscopic ultrasound (EUS) aspiration needle. Although general anaesthetic for IGB removal remains contentious, we felt this represented the safest strategy given the risk of aspiration as well as the lack of prior experience at our centre.