*3.1.1.1 Technique*

The TOGA is an incision free procedure performed under general anesthesia creating a restrictive pouch in the stomach using a set of flexible staplers which are introduced endoscopically. Using suction, tissue from both the anterior and posterior wall of the stomach is positioned together into two vacuum pods inside the device. Hereafter, 3 rows of 11 titanium staples create a serosa to serosa transmural suture, connecting the anterior and posterior gastric walls from the angle of His

to the lesser curvature. This step is repeated until one has created a sleeve of the desired length. The sleeve outlet is then narrowed using the TOGA restrictor.
