*3.1.5.1 Technique*

With an outer diameter of 16 mm, the device has a built-in channel for a 5-mm endoscope. The stapler head, located at the distal part of the device, is able to rotate 360° and orientate into complete flexion or retroflexion. When introduced into the stomach, it is able to create a vacuum inside its silicone cover, to capture the desired amount of stomach tissue. After ensuring an adequate amount, the acquired piece of stomach tissue will be compressed by a 10-mm plastic ring with eight titanium staples, thereby creating a large, full-thickness transmural plication. After preloading the system with a new staple cartridge, creation of new plications can be continued in the same fashion. After a maximum of eight plications in the fundus together with an additional two in the antrum of the stomach, reduction of stomach volume alongside the greater curvature is completed. The two extra plications in the antrum of the stomach are believed to delay gastric emptying.
