***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Background Endoscopic sutured gastroplasty ( ESG ) has evolved over time . With the advent of full-thickness endoscopic suturing , an efficient technique for ESG was developed and refined . Methods This prospect i ve first-in-man trial started in April 2012 and represents the first use of full-thickness endoscopic suturing for primary obesity therapy . The trial focused on procedure development , reproducibility , safety , and short-term efficacy . The trial was performed at centers in five countries , in three phases . Phase I was evaluation of safety and technical feasibility of various procedure techniques ; stitch patterns and sequences were assessed for efficiency , safety , and feasibility . Phase II entailed continued procedure refinement to establish a st and ardized technique . Phase III entailed evaluation of technical feasibility and weight loss outcomes in 77 patients ; the procedure was performed using the st and ardized technique , and there was no procedure development . Data were prospect ively collected into a registry . Results In Phase I , the procedure was created and modified to improve time efficiency . Safety and technical feasibility were established , and short-term weight loss was demonstrated . In Phase II , a number of stitch patterns were attempted , and the stitch pattern was modified and finalized . 22 patients were included , and 1-year total weight loss was 17.3 ± 2.6 % . In Phase III , conformity with the final technique was high . 77 patients were included , with a mean BMI of 36.1 ± 0.6 kg/m2 . Mean weight loss was 16.0 ± 0.8 % at 6 months and 17.4 ± 1.2 % at 12 months ( n = 44 ) . Postprocedural nausea , vomiting , and epigastric pain were frequently reported ; there were no reported significant adverse events post-procedure or during the follow-up period . Conclusions Following a method ical procedure development phase , ESG  demonstrated safety and short-term efficacy in this trial . The procedure also achieved meaningful weight loss during the follow-up period Background and study aims : Bariatric endoscopy has emerged as an aid in the nonsurgical treatment of obesity . The objective of this study is to critically provide the results and follow-up of endoscopic sleeve gastroplasty 1 year after the procedure . Patients and methods : Prospect i ve single-center follow-up study of 25 patients ( 5 men , 20 women ) who underwent flexible endoscopic suturing for endoluminal gastric volume reduction .  A multidisciplinary team provided post-procedure care . Patient outcomes were recorded at 1 year after the procedure . Linear regression analysis was done to evaluate the variables associated with best results at 1 year of follow-up . Results :  Mean body mass index ( BMI ) was 38.5 ± 4.6 kg/m2 ( range 30 – 47 ) and mean age 44.5 ± 8.2 years ( range 29 – 60 ) . At 1 year , 22 patients continued with the follow-up ( 2 dropped out at 6 months and 1 at 3 months ) . There were no major intra-procedural , early , or delayed adverse events . Mean BMI loss was 7.3 ± 4.2 kg/m2 , and mean percentage of total body weight loss was 18.7 ± 10.7 at 1 year . In the linear regression analysis , adjusted by initial BMI , variables associated with % TBWL involved the frequency of nutritional ( β = 0.563 , P = 0.014 ) and psychological contacts ( β = 0.727 , P = 0.025 ) . The number of nutritional and psychological contacts were predictive of good weight loss results . Conclusions : Endoscopic sleeve gastroplasty is a feasible , reproducible , and effective procedure to treat obesity . Nutritional and psychological interaction are predictive of success BACKGROUND Many obese patients can not lose weight or reject conventional obesity management . Endoscopic sleeve gastroplasty ( the Apollo method ) is a pioneering coadjuvant , interventionist technique for the integral management of obesity . OBJECTIVES The goals of this study were to report safety and efficacy results obtained at 6 months in patients undergoing endoscopic sleeve gastroplasty .  MATERIAL AND METHODS A prospect i ve study was performed in 55 patients ( 13 males , 42 females ) who were subjected to the Apollo technique ; mean age was 43.5 years ( range 25 - 60 ) and mean BMI was 37.7 kg/m2 ( range 30 - 48 ) . All received multidisciplinary follow-up for weight loss . Weight changes and presence of complications were assessed . Through the endoscope a triangular pattern suture is performed consisting of approximately 3 - 6 transmural ( mucosa to serosa ) stitches , using a cinch device to bring them nearer and form a plication . RESULTS A total of 6 - 8 plications are used to provide a tubular or sleeve-shaped restriction to the gastric cavity . No major complications developed and patients were discharged at 24 hours following the procedure . Endoscopic and radiographic follow-up at 6 months post-procedure showed a well preserved tubular form to the stomach . After 6 months patients had lost 18.9 kg and 55.3 % of excess weight . CONCLUSIONS Endoscopic sleeve gastroplasty , together with dietary and psycho-behavioral changes , is a safe , effective technique in the coadjuvant management of obese patients ABSTRACT Background : Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity . Aim : To evaluate endoscopic sleeve gastroplasty ( Apollo method ) using a suturing method directed at the greater curvature , as well as the perioperative care , two year safety and weight loss . Method : Prospect i ve single-center study over 154 patients ( 108 females ) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation . Of the154 initial patients , 143 were available for 1-month of follow-up , 133 for 6-month , 64 for 12-month and 28 completed the 24 month assessment . Follow-up was carried out by a multidisciplinary team ( nutritionist and psychologist ) . Outcomes evaluated were : change in BMI ; change in body weight ( TBWL ) ; % of loss of initial body weight ( % TBWL ) ; % of excess body weight loss ( % EWL ) ( segregated in > or < 25 % and adverse effects . Voluntary oral contrasted radiological examinations were scheduled to assess the gastroplasty at different times post-procedure . Results : Mean age was 44.9 ( 23 - 69 ) years . At 24 months after the procedure baseline mean BMI change from 38.3 to 30.8 kg/m2 . TBWL , % TBWL and % EWL were of 21.3 kg , 19.5 % and 60.4 % respectively . 85.7 % of patients achieve the goal of > 25 % % EWL . There were no mayor adverse events intraprocedure or during the 24 months of follow-up . Conclusion : Endoscopic sleeve gastroplasty with regular monitoring by a multidisciplinary team can be considered an effective , safe and well tolerated procedure for obesity treatment , at least for two years of follow-up BACKGROUND AND STUDY AIMS Emerging endoscopic techniques are minimally invasive and can mimic the anatomic alterations achieved by surgical sleeve gastrectomy . The objective of this study was to evaluate endoscopic sleeve gastroplasty . PATIENTS AND METHODS This was a prospect i ve , single-center study of 20 patients who underwent flexible endoscopic suturing for endoluminal gastric volume reduction .  A multidisciplinary team provided postprocedure care . Patient status and weight were recorded at baseline , and at 1 , 3 , and 6 months after the procedure . RESULTS There were no adverse events and all patients were discharged in less than 24 hours .  Baseline mean body mass index was 38.5 kg/m(2 ) , and mean age was 45.8 years . Initial body weight ( 108.5 ± 14.9 kg ) was significantly reduced . Following the procedure , the mean body weight reduction was 8.2 ± 2.5 kg at 1 month ( % of initial weight loss 7.6 % ; P < 0.05 ) , 13.6 ± 4.8 kg at 3 months ( 12.4 % weight loss ; P < 0.05 ) , and 19.3 ± 8.9 kg at 6 months ( 17.8 % weight loss ; P < 0.05 ) . CONCLUSION Endoscopic sleeve gastroplasty can be effective for the treatment of patients with obesity BACKGROUND In short-term r and omized trials ( duration , 1 to 2 years ) , bariatric surgery has been associated with improvement in type 2 diabetes mellitus . METHODS We assessed outcomes 3 years after the r and omization of 150 obese patients with uncontrolled type 2 diabetes to receive either intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy .  The primary end point was a glycated hemoglobin level of 6.0 % or less . RESULTS The mean ( ±SD ) age of the patients at baseline was 48±8 years , 68 % were women , the mean baseline glycated hemoglobin level was 9.3±1.5 % , and the mean baseline body-mass index ( the weight in kilograms divided by the square of the height in meters ) was 36.0±3.5 . A total of 91 % of the patients completed 36 months of follow-up . At 3 years , the criterion for the primary end point was met by 5 % of the patients in the medical-therapy group , as compared with 38 % of those in the gastric-bypass group ( P<0.001 ) and 24 % of those in the sleeve-gastrectomy group ( P=0.01 ) . The use of glucose-lowering medications , including insulin , was lower in the surgical groups than in the medical-therapy group . Patients in the surgical groups had greater mean percentage reductions in weight from baseline , with reductions of 24.5±9.1 % in the gastric-bypass group and 21.1±8.9 % in the sleeve-gastrectomy group , as compared with a reduction of 4.2±8.3 % in the medical-therapy group ( P<0.001 for both comparisons ) . Quality -of-life measures were significantly better in the two surgical groups than in the medical-therapy group . There were no major late surgical complications . CONCLUSIONS Among obese patients with uncontrolled type 2 diabetes , 3 years of intensive medical therapy plus bariatric surgery result ed in glycemic control in significantly more patients than did medical therapy alone . Analyses of secondary end points , including body weight , use of glucose-lowering medications , and quality of life , also showed favorable results at 3 years in the surgical groups , as compared with the group receiving medical therapy alone . ( Funded by Ethicon and others ; STAMPEDE Clinical Trials.gov number , NCT00432809 . ) BACKGROUND & AIMS : Although bariatric surgery is the most effective therapy for obesity , only a small proportion of c and i date s undergo this surgery . Endoscopic sleeve gastroplasty ( ESG ) is a minimally invasive procedure that reduces the size of the gastric reservoir . We investigated its durability and effects on body weight and gastrointestinal function in a prospect i ve study of obese individuals . METHODS : Twenty‐five obese individuals ( 21 female ; mean body mass index , 35.5 ± 2.6 kg/m2 ; mean age , 47.6 ± 10 years ) underwent ESG with endoluminal creation of a sleeve along the gastric lesser curve from September 2012 through March 2015 at the Mayo Clinic in Rochester , Minnesota . Subjects were followed for a median period of 9 months . We measured changes in body weight and recorded adverse events ; patients were assessed by endoscopy after 3 months . Four participants underwent pre‐ESG and post‐ESG analyses to measure solid and liquid gastric emptying , satiation ( meal tolerance ) , and fasting and postpr and ial levels of insulin , glucose , and gut hormones . RESULTS : Subjects had lost 53 % ± 17 % , 56 % ± 23 % , 54 % ± 40 % , and 45 % ± 41 % of excess body weight at 6 , 9 , 12 , and 20 months , respectively , after the procedure ( P < .01 ) . Endoscopy at 3 months showed intact gastroplasty in all subjects . After ESG , physiological analyses of 4 participants showed a decrease by 59 % in caloric consumption to reach maximum fullness ( P = .003 ) , slowing of gastric emptying of solids ( P = .03 ) , and a trend toward increased insulin sensitivity ( P = .06 ) . Three patients had serious adverse events ( a perigastric inflammatory collection , a pulmonary embolism , and a small pneumothorax ) but made full recoveries with no need for surgical interventions . No further serious adverse events occurred after the technique was adjusted . CONCL 
    Output:
    
ESG is a safe and effective procedure for primary obesity therapy with promising short- and mid-term results