The author discusses four fundamental aspects of the balloon procedure in which it contradicts conventional detachment surgery, but which are preconditions for accepting this procedure: (1) the balloon is unsecured by sutures, (2) disappearance of subretinal fluid is induced by a balloon being compressed in the parabulbar space, (3) the balloon implies a temporary tamponade of the break and (4) after the first week the break is secured only by thermally induced adhesions. New instruments for the balloon procedure are introduced: the balloon forceps, the Kombideller (a special indentor), and the Lincoff-Kreissig balloon, which is supplemented by a removable stylette and markings on the catheter. The guidelines for the balloon surgeon are described in detail and summarized in six rules.