Obesity Surgery最新文献

{"title":"Role of Anatomical Structure Recognition in Enhancing the Safety and Efficiency of Initial Optical Trocar Insertion in Patients with Obesity Who Underwent Laparoscopic Sleeve Gastrectomy.","authors":"Yuichi Endo, Hiroomi Takayama, Hiroki Orimoto, Shun Nakamura, Wataru Miyoshino, Yuiko Nagasawa, Yoko Kawano, Takashi Masuda, Teijiro Hirashita, Masafumi Inomata","doi":"10.1007/s11695-025-07931-4","DOIUrl":"https://doi.org/10.1007/s11695-025-07931-4","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of obesity has risen significantly, thereby resulting in a consequential increase in the use of bariatric surgical procedures. Optical trocars are extensively utilized for identifying laparoscopic access in patients with morbid obesity. However, their efficacy and safety are dependent on the surgeon's capability to accurately identify anatomical structures during insertion. The current study investigated the influence of anatomical structure recognition and insertion time on successful optical trocar insertion, which can offer insights that are applicable to various surgical specialties.</p><p><strong>Methods: </strong>This retrospective study was conducted on 143 patients who underwent laparoscopic sleeve gastrectomy. Data on demographic characteristics, comorbidities, anatomical structure recognition, and trocar insertion time were collected. To evaluate the associations between these factors, a statistical analysis using the univariate and multivariate models was performed.</p><p><strong>Results: </strong>The recognition of anatomical structures such as the rectus abdominis and peritoneum during the procedure was significantly related to shorter insertion times (p < 0.01). Multivariate analysis revealed that an accurate identification of these structures independently contributed to an efficient trocar placement. The risk of complications increased in cases where the peritoneum could not be clearly identified. However, there were no cases of major vascular or organ injuries, and all complications were managed with conservative treatment.</p><p><strong>Conclusions: </strong>Successful trocar insertion in patients with morbid obesity is dependent on the precise recognition of anatomical structures, particularly the rectus abdominis and peritoneum. This approach enhances both procedural safety and efficiency, and the findings may have broader applicability to laparoscopic techniques.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediately-Patent Magnetic Duodeno-Ileal Anastomosis (IMPA-DI): The First-in-Human Study.","authors":"Mohit Bhandari, Manoel Galvao Neto, Vitor Ottoboni Brunaldi, Mahak Bhandari, Winnie Mathor, Manoj Reddy, Andre Teixeira, Erik B Wilson","doi":"10.1007/s11695-025-07823-7","DOIUrl":"10.1007/s11695-025-07823-7","url":null,"abstract":"<p><strong>Background: </strong>Duodeno-ileal anastomoses are technically challenging and associated with high complication rates, limiting their adoption in bariatric surgery despite their efficacy in weight loss. Magnetic compression anastomoses (MCAs) have emerged as a promising technique, promoting tissue fusion and reducing risks of bleeding and leakage. However, delayed patency limits their application. The OTOLoc™ system, combined with Flexagon self-forming magnets (SFMs), addresses this limitation by enabling immediate patency during healing. This study reports the first-in-human experience of immediately patent magnetic duodeno-ileal anastomosis (IMPA-DI) using these novel devices during single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S).</p><p><strong>Methods: </strong>This single-center, observational study evaluated the feasibility and short-term safety of IMPA-DI. Seven adult patients with moderate to severe obesity were included. The SFM assembly, coupled with the OTOLoc™ system, was laparoscopically deployed to create an immediately patent duodeno-ileal anastomosis. Primary endpoints were technical success and freedom from anastomosis-related adverse events (AEs) within 30 days. Secondary outcomes included procedural metrics and overall safety.</p><p><strong>Results: </strong>All seven procedures were successfully completed, with a median overall duration of 58 min and magnet placement duration of 12 min. Three intraoperative AEs (serosal and liver injuries, staple line bleeding) were unrelated to IMPA and resolved without complications. All patients resumed liquid diets within 2 days, and no anastomosis-related AEs were observed within 30 days. All devices were naturally expelled without complications.</p><p><strong>Conclusions: </strong>This first-in-human study demonstrates the feasibility, safety, and efficiency of the IMPA-DI approach using Flexagon SFMs and the OTOLoc™ system. The immediate patency and straightforward deployment highlight the potential for broader application in challenging anastomotic sites. While limited by the small sample size and single-center design, the results underscore the promise of magnetic compression anastomoses. Further studies are warranted to validate these findings and explore long-term outcomes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2053-2058"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Early Days of Laparoscopic Sleeve Gastrectomy: A Narrative Review.","authors":"Eduardo Lemos de Souza Bastos","doi":"10.1007/s11695-025-07859-9","DOIUrl":"10.1007/s11695-025-07859-9","url":null,"abstract":"<p><p>Laparoscopic sleeve gastrectomy (LSG) is recognized as a safe and effective stand-alone metabolic and bariatric surgery (MBS). Several appealing features of the procedure have made LSG the most performed MBS over the past decade. The current popularity of LSG can be traced back to the vision of pioneering surgeons who believed in the potential of the procedure. They deserve acknowledgment for their contributions, and doing so is timely and fair. Therefore, this narrative review aims to recount the early days of LSG.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2303-2309"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic vs Laparoscopic Sleeve Gastrectomy in Patients with BMI > 40 kg/m² (Class ≥ III Obesity): A Systematic Review and Meta-Analysis.","authors":"Konstantinos Kossenas, Riad Kouzeiha, Olga Moutzouri, Filippos Georgopoulos","doi":"10.1007/s11695-025-07881-x","DOIUrl":"10.1007/s11695-025-07881-x","url":null,"abstract":"<p><strong>Background: </strong>Class III obesity (BMI ≥ 40 kg/m²) is a growing global health concern, often managed with bariatric surgery. A major surgical intervention is sleeve gastrectomy, which can be performed either robotically (RSG) or laparoscopically (LSG). However, there is limited data with regards to RSG vs LSG outcomes for patients with Class III obesity or greater.</p><p><strong>Methods: </strong>We adhered to PRISMA 2020 guidelines and Cochrane handbook. We examined studies that included patients with obesity Class III or greater who had undergone RSG and were compared to LSG. We collected data regarding the peri-operative outcomes and we analysed them using random effects models with mean differences or odds ratios. Sensitivity analysis was performed for outcomes with moderate to high heterogeneity.</p><p><strong>Results: </strong>A total of seven studies were included in the meta-analysis, with a total of 63,286 patients (5,314 RSG and 57,972 LSG). No significant differences were observed in the length of hospital stay between RSG and LSG (MD: 0.06, 95% CI: -0.19 to 0.31, I² = 81%, P = 0.63). Operative duration was significantly longer for RSG compared to LSG (MD: 27.47, 95% CI: 26.15 to 28.79, I² = 0%, P < 0.00001). Readmission rates showed no significant differences between the two approaches (OR: 1.14, 95% CI: 0.67 to 1.92, I² = 41%, P = 0.64). Conversion rates, surgical site infections, and bleeding events also had no significant differences between RSG and LSG (conversion OR: 0.48, 95% CI: 0.15 to 1.61; SSI OR: 0.32, 95% CI: 0.06 to 1.68; bleeding OR: 0.86, 95% CI: 0.55 to 1.34; all with I² = 0%). Sensitivity analysis revealed no significant impact of individual studies on the pooled estimates, except for a decrease in heterogeneity for readmission rates after excluding one study.</p><p><strong>Conclusion: </strong>With the available limited evidence, robotic sleeve gastrectomy does not convey any substantial benefits over the conventional laparoscopic approach. However, due to the limited number of studies identified as well as the small number of studies retained for some outcomes, caution is needed when interpreting the results. Future research is required to examined the estimated weight loss and draw definitive conclusions.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2333-2341"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Metabolic Surgery in Recurrent Hypertriglyceridemia-Induced Acute Pancreatitis: Study Limitations and Future Directions.","authors":"Weizheng Xie, Jian Li","doi":"10.1007/s11695-025-07922-5","DOIUrl":"10.1007/s11695-025-07922-5","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2028-2029"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Machine Learning and Dynamic Digital Follow-up for Enhanced Prediction of Postoperative Complications in Bariatric Surgery.","authors":"Eleonora Farinella, Dimitrios Papakonstantinou, Nikolaos Koliakos, Marie-Thérèse Maréchal, Mathilde Poras, Luca Pau, Otmane Amel, Sidi Ahmed Mahmoudi, Giovanni Briganti","doi":"10.1007/s11695-025-07894-6","DOIUrl":"10.1007/s11695-025-07894-6","url":null,"abstract":"<p><strong>Background: </strong>Traditional risk models, such as POSSUM and OS-MS, have limited accuracy in predicting complications after bariatric surgery. Machine learning (ML) offers new opportunities for personalized risk assessment by incorporating artificial intelligence (AI). This study aimed to develop and evaluate two ML-based models: one using preoperative clinical data and another integrating postoperative data from a mobile application.</p><p><strong>Methods: </strong>A prospective study was conducted on 104 bariatric surgery patients at Saint-Pierre University Hospital (September 2022-July 2023). Patients used the \"Care4Today\" mobile app for real-time postoperative monitoring. Data were analyzed using ML algorithms, with performance evaluated via cross-validation, accuracy, F1 scores, and AUC. A preoperative model used demographic and surgical data, while a postoperative model incorporated symptoms and mobile app-generated alerts.</p><p><strong>Results: </strong>A total of 104 patients were included. The preoperative model, utilizing Extreme linear discriminant analysis, achieved an accuracy of 75% and an AUC of 64.7%. The postoperative model, using supervised logistic regression with six selected features, demonstrated improved performance with an accuracy of 77.4% and an AUC of 71.5%. A user interface was developed for clinical implementation.</p><p><strong>Conclusions: </strong>ML-based predictive models, particularly those integrating dynamic postoperative data, improve risk stratification in bariatric surgery. Real-time mobile health monitoring enhances early complication detection, offering a personalized, adaptable approach beyond traditional static risk models. Future validation with larger datasets is necessary to confirm generalizability.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2202-2209"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed Food Intake is Inversely Associated with Cooking Skills in Post-metabolic and Bariatric Surgery Individuals: A Cross-sectional study.","authors":"Rodrigo Carnaúba, Carine Vieira, Thayná Oliveira, André Eduardo Silva-Júnior, Mateus Macena, Nassib Bueno","doi":"10.1007/s11695-025-07879-5","DOIUrl":"10.1007/s11695-025-07879-5","url":null,"abstract":"<p><strong>Purpose: </strong>Cooking skills seem to influence individuals' consumption of ultra-processed foods (UPF). However, there are no studies evaluating this relationship in people who have undergone metabolic and bariatric surgery (MBS). This study aimed to assess the association between UPF consumption and the cooking skills of individuals after MBS.</p><p><strong>Material and method: </strong>This is a cross-sectional, online, nationwide study. Cooking skills were assessed using the cooking skills index (CSI), and UPF consumption was measured using the NOVA-UPF score. Data was also collected on sex, age, body mass index (BMI), economic classification, surgical technique, time since surgery, and whether the reported consumption was at the weekend to be included as adjustment variables in the relationship between the NOVA-UPF score and the CSI.</p><p><strong>Results: </strong>The study included 1525 individuals with a mean of 37.90 (SD 54.12) months who had undergone MBS (median 12 months), an age of 38.53 (8.02) years, and a BMI of 29.97 (5.82) kg/m². The participants scored an average of 7.84 (SD 1.93) for the CSI and 2.75 (2.19) for the NOVA-UPF score. The CSI was negatively associated with the NOVA-UPF score (β =  - 0.12; 95%CI =  - 0.18; - 0.06), even after adjusting for sex, age, body mass index, economic classification, surgical technique, surgery time, weekend food consumption, marital status, diabetes, and hypertension (β =  - 0.12; 95%CI =  - 0.17; - 0.07). This negative association was also observed in the analysis of the prevalence of food intake in subgroups from the NOVA-UPF score, namely processed drinks, processed meats, sweets, and margarine.</p><p><strong>Conclusion: </strong>CSI is negatively associated with UPF consumption in individuals undergoing MBS.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2121-2131"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BariClip: Laparoscopic Treatment of Postoperative Perforation.","authors":"Raffaele Galleano, Massimo Ciciliot, Umberto Cosce, Abid Qureshi, Omar Ghazouani","doi":"10.1007/s11695-025-07867-9","DOIUrl":"10.1007/s11695-025-07867-9","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2381-2383"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Gastric Bypass vs Sleeve Gastrectomy on Remission of Type 2 Diabetes Mellitus Among Patients with Severe Obesity: A Meta-Analysis.","authors":"Suelen Queiroz, Júlia Gonçalves Gadelha, Noor Husain, Cristina Sicorschi Gutu","doi":"10.1007/s11695-025-07858-w","DOIUrl":"10.1007/s11695-025-07858-w","url":null,"abstract":"<p><strong>Background: </strong>Obesity and type 2 diabetes mellitus (T2DM) are global health crises, with bariatric surgery emerging as a key intervention. However, the comparative efficacy of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) in achieving diabetes remission remains debated.</p><p><strong>Methods: </strong>This PRISMA-compliant meta-analysis included three randomized controlled trials (RCTs, n = 613 patients) comparing RYGB and SG in adults with severe obesity (BMI ≥30 kg/m²) and T2DM.</p><p><strong>Primary outcome: </strong>diabetes remission (HbA1c 6.0%). Risk of bias was assessed via Cochrane RoB-2 tool; statistical analysis used fixed-effect models (I²=0%).</p><p><strong>Results: </strong>RYGB demonstrated superior diabetes remission rates vs. SG (OR 2.77, 95% CI 1.83-4.20, p0.001), with no heterogeneity. Subgroup analyses confirmed consistency across studies. Mean follow-up was ≤5 years; baseline demographics were comparable (mean age 46.2 years, 53.4% male).</p><p><strong>Conclusion: </strong>RYGB significantly outperforms SG in achieving T2DM remission, likely due to its combined restrictivemalabsorptive mechanisms and metabolic hormonal effects. These findings support RYGB as the preferred surgical option for obese patients with T2DM, though long-term studies are needed to assess durability.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2296-2302"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on: The Effects of Intraperitoneal Dexmedetomidine in Comparison with Ropivacaine in Postoperative Pain After Laparoscopic Sleeve Gastrectomy: A Double-Blind, Randomized, Placebo-Controlled, Clinical Trial.","authors":"Jiayi Deng, Hanbin Wang, Liang Yu","doi":"10.1007/s11695-025-07921-6","DOIUrl":"10.1007/s11695-025-07921-6","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2026-2027"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}