Background: Laparoscopic bariatric operations can be technically challenging in massively obese patients. The potential of the intragastric balloon for preoperative weight reduction was evaluated in candidates for laparoscopic Roux-en-Y gastric bypass (LRYGBP) with super obesity. Methods: From January 2004 to March 2005, 10 patients with super obesity who were potential candidates for LRYGBP were included in a prospective observational study. An intragastric balloon was placed endoscopically under general anesthesia. Patients were then followed by a multidisciplinary team until removal of the balloon after 6 months. Weight, BMI, and percent excess weight lost (%EWL) were monitored after 1, 3 and 6 months. Results: The 10 patients were all female with mean +/- SD age of 33 +/- 01 years (range 17-51). Initial weight was 175 +/- 25 kg (range 135-223) and initial BMI was 64 +/- 7 kg/m(2) (range 59-78). After completion of 1, 3 and 6 months, weight, BMI, and %EWL reached respectively: 166 +/- 27 kg*, 165 +/- 27 kg*, and 169 +/- 26 kg*; 61.1 +/- 7.6 kg/m(2)*, 60.8 +/- 8.4 kg/m(2)*, and 61 +/- 8.2 kg/ml*; 9 +/- 5%,10 +/- 7%,7 +/- 6%. (*=P < 0.01 vs preop). Conclusion: In potential candidates for LRYGBP with super obesity, preoperative placement of an intragastric balloon can reduce the excess weight by 10% within 3 months. Extending this period failed to improve these results further.