Endolumenal Gastric Pouch and Gastrojejunal Anastomosis Reduction

Inclusion Criteria: 1. Patient is \> 18 years of age and \< 65 years of age 2. Patient is \> 2 yrs post-Roux-en-Y bypass surgery 3. Patient initially achieved \> 50% EWL after Roux-en-Y bypass surgery 4. Patient is a reasonable risk to undergo general anesthesia 5. Patient is able to provide written informed consent Exclusion Criteria: 1. Patient has an esophageal stricture or other anatomy/condition that would preclude the use and passage of the endolumenal instruments 2. Physician determines another causal factor for weight regain other than stoma or pouch dilation 3. Patient is non-mobile or has significant impairment of mobility that will limit compliance with post-op exercise