Gastric perforation by intragastric balloon: Laparoscopic gastric wedge resection can be a strategy?

•Gastric perforation caused by intragastric balloon represents a rare but life-threatening complication.•There is a lack of information about perforation in the same day of surgery.•An endoscopic and laparoscopic approach with a gastric wedge resection was performed. IGB (Intragastric Balloon) is acknowledged to be a safe and secure device, whose outcomes in terms of weight loss are widely discussed. Bariatric community has soon noted tolerance and benefit of this tool, considered a first and easy step before bariatric surgery. Nevertheless, some authors have described a series of complications that, although rare, could be life threatening and hard to manage, as a gastric perforation. We reported a case of a 55-year-old obese woman, undergone placement of IGB device heisting in a gastric perforation. In the same day of surgery, we performed an emergency, applying a combined endoscopic and laparoscopic approach, to remove the balloon and to close perforation by a gastric resection. Discussion. Short term outcome was satisfactory, and the patient had a successful further follow up and weight loss. IGB is a valuable tool among bariatric procedure, nevertheless the surgeon has to consider the possible and life-threatening complications and to provide a multidisciplinary equip to face this occurrence.