Safety and Efficacy Study of Duet TRS

Inclusion Criteria: * The patient must be 18-65 years of age. * The patient has a BMI of 40-60 kg/m2 or 35-40 kg/m2 with comorbidities * The patient must be willing and able to participate in the study procedures and able to understand and sign the informed consent. Exclusion Criteria: * The procedure is needed as revision bariatric surgery or the patient has had prior gastric surgery (nissen fundoplication, hiatal hernia, etc) * The patient is pregnant. * The patient has an active, or history of, infection at the operative site. * The patient is unable or unwilling to comply with the study requirements, follow-up schedule, or to give valid informed consent. * Patient has an abdominal ventral hernia * The patient has a history of liver disease * The patient has a history of drug or alcohol abuse * The patient has a history of venous thrombosis or pulmonary embolism * The patient has a history of coagulopathy