***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: INTRODUCTION The South Pacific has a high prevalence of obesity and super-obesity . We review ed our experience with laparoscopic sleeve gastrectomy ( LSG ) to evaluate its efficacy and safety . METHODS A retrospective review of a prospect ively collected data base of LSGs carried out by one surgeon in one center . The percentage of excess weight loss and the rate of resolution or improvement of comorbidities reflected efficacy , and major complications or mortalities reflected safety . RESULTS From January 2008 to February 2013 , we performed 510 surgeries and included 494 consecutive patients ( 367 females ) ( 45.5 ± 11.2 years ) in our study .  LSG was the primary procedure in 384 patients , 6 patients had redo bariatric surgery after failure of initial LSG , 57 patients had a history of gastric b and ing with insufficient weight loss or b and -related complications , and 46 super-obese patients had an intragastric balloon placed before LSG . Average starting body mass index was 47.8 kg m(-2 ) . Mean percent excess weight loss was 64.3 % at 1 year ; 67.3 % at 2 years and 66.4 % at 3 years . The percentages of resolved comorbidities were as follows : hypertension : 48.3 % , type 2 diabetes mellitus : 72.5 % , dyslipidemia : 61.0 % , and obstructive sleep apnea : 77.8 % . The mortality rate was 1/494 . The postoperative morbidity included gastric fistula in 3.0 % , hemorrhaging in 2.4 % , and postoperative gastroesophageal reflux in 9.4 % . CONCLUSIONS In the South Pacific , LSG is a safe and effective means of treating morbid obesity with sustained weight loss and resolution of comorbid medical conditions Background Laparoscopic sleeve gastrectomy ( LSG ) is emerging as a popular “ st and -alone ” bariatric procedure . We report our 5 years experience with LSG as a single-stage bariatric procedure with which to study the technical progress , learning curve , complications , and follow-up results . Methods Prospect ively collected data of 228 patients ( 145 females and 83 males ) , who underwent LSG for morbid obesity , from February 2007 to March 2012 , was retrospectively analyzed . Results The mean age was 34.68 years ( range , 18–62 years ) and the mean preoperative body mass index ( BMI ) was 37.42 ± 4.75 kg/m2 ( range , 32.08–65.69 kg/m2 ) . Mean operative time was 60.63 ± 27.37 min . The mean BMI decreased to 26.15 ± 3.71 kg/m2 at 3 years ( p < 0.001 ) and to 27.94 ± 4.08 kg/m2 at 5 years ( p < 0.001 ) . Mean percentage excess weight loss was 71.96 ± 21.30 % at 3 years and 63.71 ± 20.08 % at 5 years . The 30-day readmission rate was 3.07 % .Overall complication rate was 4.3 % , including strictures , leaks , peritonitis , gastrocutaneous fistula , and one ( 0.43 % ) mortality . One patient with weight regain and another with stricture underwent conversion to Roux-en-Y gastric bypass  . Complication rates significantly decreased after the first 50 cases ( p = 0.022 ) , suggesting an initial learning curve . Resolution of diabetes , hypertension , and hyperlipidemia was 66.67 , 100 , and 50 % , respectively , at 5 years . Conclusions LSG as a single-stage bariatric procedure is safe and durable , achieving weight loss and resolution of comorbidities up to 5 years . Adherence to technical details is pivotal in reducing complications associated with the initial learning phase 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 Importance Sleeve gastrectomy is increasingly used in the treatment of morbid obesity , but its long-term outcome vs the st and ard Roux-en-Y gastric bypass procedure is unknown . Objective To determine whether there are differences between sleeve gastrectomy and Roux-en-Y gastric bypass in terms of weight loss , changes in comorbidities , increase in quality of life , and adverse events . Design , Setting , and Participants The Swiss Multicenter Bypass or Sleeve Study ( SM-BOSS ) , a 2-group r and omized trial , was conducted from January 2007 until November 2011 ( last follow-up in March 2017 ) . Of 3971 morbidly obese patients evaluated for bariatric surgery at 4 Swiss bariatric centers , 217 patients were enrolled and r and omly assigned to sleeve gastrectomy or Roux-en-Y gastric bypass with a 5-year follow-up period . Interventions Patients were r and omly assigned to undergo laparoscopic sleeve gastrectomy ( n = 107 ) or laparoscopic Roux-en-Y gastric bypass ( n = 110 ) . Main Outcomes and Measures The primary end point was weight loss , expressed as percentage excess body mass index ( BMI ) loss . Exploratory end points were changes in comorbidities and adverse events . Results Among the 217 patients ( mean age , 45.5 years ; 72 % women ; mean BMI , 43.9 ) 205 ( 94.5 % ) completed the trial . Excess BMI loss was not significantly different at 5 years : for sleeve gastrectomy , 61.1 % , vs Roux-en-Y gastric bypass , 68.3 % ( absolute difference , −7.18 % ; 95 % CI , −14.30 % to −0.06 % ; P = .22 after adjustment for multiple comparisons ) . Gastric reflux remission was observed more frequently after Roux-en-Y gastric bypass ( 60.4 % ) than after sleeve gastrectomy ( 25.0 % ) . Gastric reflux worsened ( more symptoms or increase in therapy ) more often after sleeve gastrectomy ( 31.8 % ) than after Roux-en-Y gastric bypass ( 6.3 % ) . The number of patients with reoperations or interventions was 16/101 ( 15.8 % ) after sleeve gastrectomy and 23/104 ( 22.1 % ) after Roux-en-Y gastric bypass . Conclusions and Relevance Among patients with morbid obesity , there was no significant difference in excess BMI loss between laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass at 5 years of follow-up after surgery . Trial Registration clinical trials.gov Identifier : Introduction Bariatric surgeries are the only effective long-term treatment in obese patients . The innovation of laparoscopic gastric plication ( LGP ) raised some questions about its effectiveness compared to traditionally used techniques such as laparoscopic sleeve gastrectomy ( LSG ) . We tried to answer some of these questions . Material s and Methods We investigated 70 patients in a r and omized clinical trial ( I RCT 2013123012294N5 ) from 2012 to 2015 . Thirty-five patients were r and omly assigned to each LSG or LGP group , using sealed envelope method . The body mass index ( BMI ) reduction and the percentage of excess weight loss ( % EWL ) along with % total body weight loss ( % TWL ) were primary endpoint and were assessed at follow-up periods . We recorded postoperative complications , as well . Results Two-year follow-up rate was 100 % . There were no statistically significant differences between the two groups in means of preoperative BMI . Also , postoperative follow-ups were not suggestive for a significant difference in BMI ( all p values > 0.05 ) . The mean % EWL at follow-ups showed no significant difference at any point , except for 3 and 6 months after surgery ( p value = 0.002 and 0.017 , respectively ) . This finding was confirmed by % TWL trend in 12 months after surgery . LSG patients were readmitted more than LGP patients ( seven cases vs one case , p value = 0.024 ) . Postoperative complications such as nausea and vomiting , hair loss , iron deficiency , vitamin D deficiency , and cholelithiasis were not different between the two groups . There was one death in the LGP group due to pulmonary thromboembolism . Conclusions LGP showed to be efficient regarding % EWL and % TWL reduction in short-term follow-ups with comparable postoperative complications to LSG Objective To evaluate 8-year weight losses achieved with intensive lifestyle intervention ( ILI ) in the Look AHEAD ( Action for Health in Diabetes ) study . Design and Methods Look AHEAD assessed the effects of intentional weight loss on cardiovascular morbidity and mortality in 5,145 overweight/obese adults with type 2 diabetes , r and omly assigned to ILI or usual care ( i.e. , diabetes support and education [ DSE ] ) .  The ILI provided comprehensive behavioral weight loss counseling over 8 years ; DSE participants received periodic group education only . Results All participants had the opportunity to complete 8 years of intervention before Look AHEAD was halted in September 2012 ; ≥88 % of both groups completed the 8-year outcomes assessment . ILI  and DSE participants  lost ( mean±SE ) 4.7±0.2 % and 2.1±0.2 % of initial weight , respectively ( p<0.001 ) at year 8 ; 50.3 % and 35.7 % , respectively , lost ≥5 % ( p<0.001 ) , and 26.9 % and 17.2 % , respectively , lost ≥10 % ( p<0.001 ) . Across the 8 years ILI participants , compared with DSE , reported greater practice of several key weight-control behaviors . These behaviors also distinguished ILI participants who lost ≥10 % and kept it off from those who lost but regained . Conclusions Look AHEAD ’s ILI produced clinical ly meaningful weight loss ( ≥5 % ) at year 8 in 50 % of patients with type 2 diabetes and can be used to manage other obesity-related co-morbid conditions . Trial Registration clinical trials.gov Identifier : 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 ( % EW 
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On comparison analysis , % TWL with LSG was superior to ESG  ( P = 0.001 ) . %
All adverse events , bleeding and gastro-esophageal reflux disease were significantly lower with ESG when compared to LSG .
Conclusion ESG demonstrates acceptable weight loss parameters and seems to have a better safety profile when compared to LSG