Hybrid Argon Plasma Coagulation and Endoscopic Sleeve Gastroplasty Trial

Inclusion Criteria: * BMI ≥ 30 and ≤40 kg/m² * Willingness to comply with the substantial lifelong dietary restrictions required by the procedure. * History of failure with non-surgical weight-loss methods. * Willingness to follow protocol requirements, including signed informed consent, routine follow-up schedule, completing laboratory tests, and completing diet counseling. * Residing within a reasonable distance from the investigator's office and able to travel to the investigator to complete all routine follow-up visits. * Ability to give informed consent. * Women of childbearing potential (i.e., not post-menopausal or surgically sterilized) must agree to use adequate birth control methods. Exclusion Criteria: * History of foregut or gastrointestinal (GI) surgery (except uncomplicated cholecystectomy or appendectomy). * Prior gastrointestinal surgery with sequelae, i.e. obstruction, and/or adhesive peritonitis or known abdominal adhesions. * Prior open or laparoscopic bariatric surgery. * Prior surgery of any kind on the esophagus, stomach, or any type of hiatal hernia surgery. * Any inflammatory disease of the gastrointestinal tract including severe (LA Grade C or D) esophagitis, Barrett's esophagus, gastric ulceration, duodenal ulceration, cancer, or specific inflammatory disease such as Crohn's disease or celiac disease. * Potential upper gastrointestinal bleeding conditions such as esophageal or gastric varices, congenital or acquired intestinal telangiectasis, or o…