We read with great interest the article by Schiefke and colleagues (Gut 2005;54:752–8) on the long term failure of endoscopic gastroplication (Endocinch). The authors reported more than 80% of patients had lost at least one suture and only 17% had all sutures in situ after 18 months (clip device). Loss of plications has been reported both with knot¹ as well as clip devices (Gut 2005;54:752–8) used for anchoring sutures but seems to be more with the later. Further studies are needed to confirm above. However, a previous study did not find a significant difference between the mean tensile failure force (tissue tear out and suture disruption) for the knot compared with the clip device anchoring …