The Endoscopic Sleeve Gastroplasty is a purely endoscopic procedure, (no incisions or stomach stapling), that reconstructs your stomach into a smaller chamber. It is performed using a video scope placed through the mouth that works in conjunction with a suturing device. The large portion of the stomach is sutured, or plicated, creating a much smaller chamber for food to be stored (see video). This makes patients feel fuller faster. This procedure is performed on patients looking to kick start their weight loss journey. Dietary changes and lifestyle modifications will need to be made in order for sustained weight loss in the long term. This procedure can often be “adjusted” in the long term to re-instill the feeling of restriction that the patient felt immediately following their initial procedure if needed.