Inclusion Criteria:  Subject without previous bariatric procedure and meets IFSO Asia-Pacific Chapter Consensus of Metabolic & Bariatric surgery criteria:  i. BMI more than 35 kg/m2 with or without co-morbidities. ii. BMI more than 30 kg/m2 with obesity related co-morbidities.  Subject without evidence of gastroesophageal reflux disease i. Symptomatic - No gastroesophageal reflux symptom (GerdQ score no greater than 7) ii. Endoscopic - No esophagitis. No Hiatus Hernia (apparent separation distance between the squamocolumnar junction and the diaphragmatic impression greater than 2 cm) iii. Functional  1. High-resolution manometry 2. 24-hour esophageal pH study 4. ASA Class I - III 5. Subject is willing to give consent and comply with evaluation and treatment scheduled  Exclusion Criteria:  Pre-existing GERD, evident symptomatically, endoscopically or upon functional testing Presence of Hiatus hernia (>2cm) or esophagitis Previous upper GI surgery (e.g. bariatric surgery, anti-reflux surgery; gastrectomy; esophageal surgery) Underlying uncontrolled endocrine problem that lead to obesity. (e.g. Hypothyroidism, Cushing syndrome, eating disorder etc) ASA grade IV & V Mental or psychiatric disorder; Drug or alcohol addiction Cirrhosis or portal hypertension Pregnant or breast feeding Any condition which precludes compliance with the study; History or presence of pre-existing autoimmune connective tissue disease Active malignant disease. Patients with malignant disease who have been disease-free for at least 5 years are eligible Active infection Life expectancy less than 12 months Special population, e.g. prisoner, mentally disabled, investigators' student or employees