This video demonstrates an endoscopic sleeve gastroplasty. The patient is a 44 year old female with a BMI of 36.4 and hyperlipidemia. The video demonstrates the use of the standard high definition upper endoscope in the stomach. The stomach tissue is marked with soft coagulation and a helix device is used to grasp the stomach tissue and pull it into the jaws so that a full thickness serosa to serosa bite is taken. The suture pattern starts on the anterior wall of the stomach and continues laterally toward the greater curvature. Four to five suture placements are used. The video shows both standalone endoscopic footage as well as side-by-side footage of the primary surgeon performing the procedure along with its endoscopic counterpart.