Thank you for your question. It is removed endoscopically under sedation or anesthesia. The water within the balloon is suctioned with a specific device until the balloon is collapsed, at which time it is removed with a special grasper. Once that is done then sedation is terminated and the procedure is concluded.
The Orbera balloon is removed using the endoscope. While under anesthesia, the endoscope is advance under direct vision down the esophagus and into the stomach where the balloon is located and punctured with a needle attached to a catheter. The fluid inside the balloon is drawn out via the catheter and discarded. Once deflated, the balloon is dragged out of the stomach to the outside along with removal of the endoscope.