['Endoscopic volume reduction of the stomach may provide a minimally invasive alternative for surgical procedures in the treatment of obesity.', 'To assess safety and preliminary effectiveness in the first human application of a novel endoscopic stapling technique.', 'Prospective, observational, phase 1 study.', 'Two university hospitals in The Netherlands.', 'Patients with a body mass index (BMI) of 40 to 45 kg/m(2) or 30 to 39.9 kg/m(2) with obesity-related comorbidity.', 'Gastric volume reduction with an endoscopic stapler.', 'Primary outcome measure was the prevalence of serious or mild adverse events. Reduction of excess body weight after 12 months was assessed as a secondary outcome measure for effectiveness of the procedure.', 'Seventeen patients with a median BMI of 40.2 kg/m(2) (interquartile range [IQR] 37.6-42.8) underwent an endoscopic stapling procedure. Median procedure time was 123 minutes (IQR 95-129). No serious adverse events occurred. Adverse events were gastric pain (n\xa0= 7, range 1-3 days), sore throat (n\xa0= 4, 2-3 days), diarrhea (n\xa0= 4, 2-15 days), nausea (n\xa0= 3, 2-4 days), constipation (n\xa0= 4, 3-14 days), and vomiting (n\xa0= 3, 1-4 days). All adverse events were mild and resolved with conservative treatment within 15 days after surgery. The median percentage excess weight loss in the first year was 34.9% (IQR 17.8-46.6).'] Is endoscopic gastric volume reduction with a novel articulating plication device safe and effective in the treatment of obesity ( with video )?