Endoscopic Suture Gastroplasty (ESG) for Treatment of Obese Patients With Endometrial Cancer

Inclusion Criteria: * Women with endometrial cancer scheduled for hysterectomy with a curative intent * Age 21-75 * BMI ≥ 30 * Willingness to undergo E-ESG and lifestyle modifications program * Willingness to comply with the substantial lifelong dietary restrictions required by the procedure * 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 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, gastric ulceration, duodenal ulceration, cancer or specific inflammation such as Crohn's disease * Potential upper gastrointestinal bleeding conditions such as esophageal or gastric varices, congenital or acquired intestinal telangiectasis, or other congenital anomalies of the gastrointestinal tract such as atresia or stenoses * Gastrointestinal stromal tumors, history of premalignant gastric lesions (advanced atrophic gastritis), history of familial and non-familial adenomatous syndromes * A gastric mass or gastric polyps \> 1 cm in size * A hiatal hernia \> 4 cm of axial displacement of the z-line above the diaphragm or severe or intractable gastro-esophageal reflux symptoms * A structural abnormality in the esophagus or pharynx such as a stricture or diverticulum that could impede passage of the endoscope * Achalasia or any other severe esophageal motility disorder * Severe coagulopathy * Subjects with any serious health condition unrelated to their weight that would increase the risk of endoscopy * Motility disorders of the GI tract such as gross esophageal motility disorders, gastroparesis, or intractable constipation * Hepatic insufficiency or cirrhosis * Use of an intragastric device prior to this study due to the increased thickness of the stomach wall preventing effective suturing * Active psychological issues preventing participation in a life-style modification program as determined by a psychologist * Patients unwilling to participate in an established medically supervised diet and behavior modification program, with routine medical follow-up * Patients who are unable or unwilling to take prescribed proton pump inhibitor medication * Patients receiving daily prescribed treatment with high dose aspirin (\> 80 mg daily), anti-inflammatory agents, anticoagulants, or other gastric irritants * Patients who are pregnant or breast-feeding * Subjects with Severe cardiopulmonary disease or other serious organic disease which might include known history of coronary artery disease, Myocardial infarction within the past 6 months, poorly controlled hypertension, required use of NSAIDs * Subjects taking medications on specified hourly intervals that may be affected by changes to gastric emptying, such as anti-seizure or anti-arrhythmic medications * Subjects who are taking corticosteroids, immunosuppressants, and narcotics * Subjects who are taking diet pills * Symptomatic congestive heart failure, cardiac arrhythmia, or unstable coronary artery disease * Pre-existing respiratory disease such as moderate or severe chronic obstructive pulmonary disease (COPD) requiring steroids, pneumonia, or cancer * Diagnosis of autoimmune connective tissue disorder (e.g., lupus, erythematosus, scleroderma) or immunocompromised * Specific diagnosed genetic disorder such as Prader Willi syndrome * Eating disorders including night eating syndrome (NES), bulimia, binge eating disorder, or compulsive overeating * Known history of endocrine disorders affecting weight such as uncontrolled hypothyroidism