RELIEF Europe Study

Inclusion Criteria: * Laparoscopic sleeve gastrectomy (LSG) for obesity \>12 months prior to proposed device implantation date. * Patient is a surgical candidate, i.e. is able to undergo general anesthesia and laparoscopic surgery. * Documented pathologic esophageal acid exposure by pH monitoring per institution's standard of care (i.e. total distal ambulatory esophageal pH\< 4 for ≥ 5.3% (BRAVO) or ≥4.5% (transnasal) or abnormal DeMeester Score (\>14.72) within 12 months of proposed implantation date (After Sleeve Gastrectomy). NOTE: SUBJECTS SHALL HAVE DISCONTINUED ALL GERD MEDICATIONS FOR AT LEAST 7 DAYS PRIOR TO TESTING WITH THE EXCEPTION OF ANTACIDS, WHICH MAY BE TAKEN UP UNTIL THE MORNING OF THE VISIT. * Chronic GERD symptoms despite maximum medical therapy for the treatment of reflux. * Age ≥ 21 years * At least 30% loss of excess weight from date of original LSG surgery. * Patient is willing and able to cooperate with follow-up examinations. * Patient has been informed of the study procedures and the treatment and has signed an informed consent form. Exclusion Criteria: * Suspected or known allergies to titanium, stainless steel, nickel, or ferrous materials. * Prior surgery in the area of the gastroesophageal junction (GEJ), including prior hiatal hernia repair. * Presence of ˃3 cm hiatal hernia as determined by endoscopy or barium esophagram. * Subject had any major complications related to the laparoscopic sleeve gastrectomy that may interfere with, or increas…