BACKGROUND: Artificial intelligence (AI), including large language models (LLMs), is increasingly transforming medicine and surgery by improving precision, efficiency, and communication. Despite significant potential, adoption is limited by technical, ethical, and regulatory challenges, requiring clinician oversight and foundational knowledge. This study assesses AI familiarity, use, and perceptions among obesity care professionals, including metabolic and bariatric surgeons and integrated health (IH) professionals. METHODS: The IFSO AI Task Force conducted a confidential online survey of metabolic bariatric surgeons and IH professionals to assess familiarity, use, benefits, concerns, barriers, and future trust regarding LLMs. The 46-item questionnaire was validated by experts, piloted, and disseminated via professional channels. Responses were analyzed descriptively, with open-ended items categorized for context, while incomplete responses were included without imputation. RESULTS: A total of 243 global metabolic bariatric surgeons and IH completed the survey. 76% had used LLMs, primarily ChatGPT, for research, presentations, patient education, and documentation, with daily or weekly use common. Respondents cited efficiency, time-saving, improved patient education, and decision support as benefits. Concerns included data privacy, bias, hallucinations, and workflow integration. Few had formal AI training. Overall, clinicians viewed LLMs as supportive assistants requiring oversight, transparency, and institutional guidance. CONCLUSION: Clinicians use LLMs cautiously in metabolic and bariatric practice, mainly for documentation, education, and information synthesis. They recognize risks, limitations, and the need for human oversight, transparency, and institutional governance. Current use reflects exploration rather than full endorsement, highlighting the importance of evaluation, training, and structured guidance as AI evolves in medicine.

This scoping review maps evidence on whether chronodisruption—defined as disturbances in sleep duration, sleep quality, sleep timing, chronotype, social jetlag (SJL), meal timing/chrononutrition, shift work, and light at night (LAN)—is associated with post-metabolic and bariatric surgery (MBS) weight outcomes (percent excess weight loss [%EWL], percent total weight loss [%TWL], body mass index [BMI] change, insufficient weight loss, and weight gain [recurrent weight gain (RWG), also termed weight regain (WR)]). Procedures include but are not limited to Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one-anastomosis gastric bypass (OAGB).

Hypocalcemia post-metabolic bariatric surgery (MBS) is a known long-term complication after hypoabsorptive procedures. However, data on immediate postoperative calcium are limited. Our aim was to evaluate the prevalence of hypocalcemia on the 1st postoperative day after MBS and correlate it with potential associated factors. We analyzed data from all consecutive index MBS over 1 year. We collected data on demographics and on preoperative and postoperative values of serum calcium (TC), albumin, adjusted calcium (AC–Payne formula), magnesium, phosphorus, preoperative vitamin-D, and postoperative 24-h urine output, intravenous fluids (IVF), bolus intravenous furosemide, and creatine phosphokinase (CPK). Continuous data are expressed as means ± SD (range). Categorical data are presented as frequencies (

Obesity and cancer represent two pandemics of current civilization, the progression of which has followed parallel trajectories. To time, thirteen types of malignancies have been recognized as obesity-related cancers, including breast (in postmenopausal women), endometrial, and ovarian cancer. Pathophysiologic mechanisms that connect the two entities include insulin resistance, adipokine imbalance, increased peripheral aromatization and estrogen levels, tissue hypoxia, and disrupted immunity in the cellular milieu. Beyond the connection of obesity to carcinogenesis at a molecular and cellular level, clinicians should always be cognizant of the fact that obesity might have secondary impacts on the diagnosis and treatment of gynecologic cancer, including limited access to effective screening programs, resistance to chemotherapy and targeted therapies, persisting lymphedema, etc. Metabolic bariatric surgery represents an attractive intervention not only for decreasing the risk of carcinogenesis in high-risk women living with obesity but most importantly as a measure to improve disease-specific and overall survival in patients with diagnosed obesity-related gynecologic malignancies. The present narrative review summarizes current evidence on the underlying pathophysiologic mechanisms, the clinical data, and the potential applications of metabolic bariatric surgery in all types of gynecologic cancer, including breast, endometrial, ovarian, cervical, vulvar, and vaginal.

Background: Endometriosis is characterized by the presence of endometrial tissue outside the uterus. Beyond medical treatment, surgical intervention is also a viable consideration. However, current guidelines do not clearly indicate whether laparoscopic cystectomy, ablative methods (CO2 laser vaporization, plasma energy), or sclerotherapy is the preferred option. Methods: We conducted searches in two databases (PubMed and Europe PMC) to retrieve articles containing the keywords ‘surgical intervention for Endometrioma, ovarian reserve, pregnancy rates, fertility’, published between 1 January 2000 and 31 December 2023. We included articles presenting information on surgical intervention for endometrioma and its correlation with infertility parameters. Articles describing conservative treatment were excluded. Data were extracted by two authors using predefined criteria. Results: The initial database search produced 1376 articles, which were narrowed down to 41 relevant articles meeting the eligibility criteria. Conclusions: Laparoscopic cystectomy appears to impact postoperative anti-mullerian hormone levels, showing a stronger correlation with larger cysts and individual factors. CO2 laser vaporization demonstrates favorable results compared to traditional cystectomy. Combining GnRH agonist treatment with assisted reproduction treatment after cystectomy could be considered an alternative method. Plasma energy causes less damage to ovarian function, with pregnancy outcomes comparable to cystectomy. Sclerotherapy shows promising results for ovarian reserve preservation, recurrence rates, and safety. Further studies comparing these techniques are necessary to provide guidance to clinicians.

The era of precision medicine necessitates standardization in reporting outcomes, in order to provide a common ground of communication among specialists and yield objective measurements at the same time. Although metabolic bariatric surgery spearheads innovation and standardization with regard to technique, this is not the case when measuring outcomes, particularly regarding weight recurrence. The multitude of definitions of weight regain and insufficient weight loss stems not only from a lack of consensus but also from the inherent deficiencies of weight- and BMI-based formulas to incorporate a global and comprehensive assessment for obesity. In this Perspective, we investigate current knowledge as well as potential amendments that will ameliorate our ability to assess weight recurrence and improve the services that we offer to people living with obesity.

Colposcopy constitutes a pivotal step in the diagnosis and management of cervical intraepithelial neoplasia; nevertheless, the method has several inherent and external limitations. Electrical impedance spectroscopic (EIS) has been among the adjuncts that have been developed to increase the diagnostic accuracy of colposcopy. EIS is based on the principle that the trajectory of electrical current alters depending on the consistency of the tissues. In the present study, we investigate the diagnostic accuracy and clinical utility of EIS by means of searching the available evidence. Our search yielded 17 articles during the period 20052023. Subsequently, we focused on the performance metrics of the included studies. The general concept is that EIS, in combination with colposcopy, is a method with increased sensitivity and specificity in detecting high-grade cervical intraepithelial neoplasia as compared to colposcopy alone. However, we documented a heterogeneous distribution of these and other metrics, including the positive predictive value, the negative predictive value, and the area under the receiver operating characteristic curve (AUC). Additionally, we located potential confounders that might hamper the measurements of EIS and, as such, warrant further investigation in future research. We conclude that future studies should be directed towards randomized multicentric trials, whereas the advent of artificial intelligence might improve the diagnostic accuracy of the method by helping incorporate a large amount of data.

Artificial intelligence (AI) is being utilized with increased frequency in the medical field, and this is the case with metabolic bariatric surgery (MBS). One of the potential utilities of AI algorithms is their role as predictive tools for postoperative complications following MBS. In this review, we attempt to accumulate the existing evidence in this field. The PRISMA statement will be followed to retrieve pertinent literature. The retrieved studies along with their key findings and metrics (including sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve) will be tabulated and summarized. The will be a discussion on the utility of our findings, as well as on how they compare to existing evidence in bariatrics and other disciplines.

BACKGROUND:Indocyanine green (ICG) is an injectable fluorochrome that has recently gained popularity as a means of assisting intraoperative visualization during laparoscopic and robotic surgery. Many systematic reviews and meta-analyses have been published. We conducted a meta-review to synthesize the findings of these studies. METHODS:PubMed and Embase were searched to identify systematic reviews and meta-analyses coping with the uses of ICG in abdominal operations, including Metabolic Bariatric Surgery, Cholecystectomy, Colorectal, Esophageal, Gastric, Hepato-Pancreato-Biliary, Obstetrics and Gynecology (OG), Pediatric Surgery, Surgical Oncology, Urology, (abdominal) Vascular Surgery, Adrenal and Splenic Surgery, and Interdisciplinary tasks, until September 2023. We submitted the retrieved meta-analyses to qualitative analysis based on the AMSTAR 2 instrument. RESULTS:We identified 116 studies, 41 systematic reviews (SRs) and 75 meta-analyses (MAs), spanning 2013-2023. The most thoroughly investigated (sub)specialties were Colorectal (6 SRs, 25 MAs), OG (9 SRs, 15 MAs), and HPB (4 SRs, 12 MAs). Interestingly, there was high heterogeneity regarding the administered ICG doses, routes, and timing. The use of ICG offered a clear benefit regarding anastomotic leak prevention, particularly after colorectal and esophageal surgery. There was no clear benefit regarding sentinel node detection after OG. According to the AMSTAR 2 tool, most meta-analyses ranked as "critically low" (34.7%) or "low" (58.7%) quality. There were only five meta-analyses (6.7%) that qualified as "moderate" quality, whereas there were no "high" quality reviews. CONCLUSIONS:Regardless of the abundance of pertinent literature and reviews, surgeons should be cautious when interpreting their results on ICG use in abdominal surgery. Future reviews should focus on ensuring methodological vigor; establishing clear protocols of ICG dose, route of administration, and timing; and improving reporting quality. Other sources of data (e.g., registries) and novel methods of data analysis (e.g., machine learning) might also contribute to an enhanced role of ICG as a decision-making tool in surgery.

Introduction/Background To date, thirteen malignancies have been recognized as obesity-related cancers, including breast (in postmenopausal women), endometrial, and ovarian. The aim of this review is to document current evidence on the underlying mechanisms, the clinical data, and the potential applications of metabolic bariatric surgery (MBS) in all types of gynecologic cancer (GC), including breast, endometrial, ovarian, cervical, vulvar, and vaginal. Methodology A literature search was performed in October 2023 via Pubmed and Google Scholar. Search terms included 'gynecologic*/breast/endometri*/uter*/ovar*/cervi*/vuvla*/vaginal' AND 'cancer/malignancy/neoplas*' AND 'obesity/adiposity' AND 'bariatric surgery/metabolic surgery/sleeve gastrectomy/bypass'. Only publications in English were included. Case reports were excluded. Particular attention was given to articles presenting pathophysiologic mechanisms, population-based studies, systematic reviews, and meta-analyses, especially those that were published in or after 2019 or to the most recent evidence available. Results Linking mechanisms between obesity and GC include insulin resistance, adipokine imbalance, increased peripheral aromatization and estrogens, tissue hypoxia, and disrupted immunity in the cellular milieu. Beyond the connection at a molecular and cellular level, clinicians should always keep in mind that obesity might have secondary impacts on the diagnosis and treatment of GC, including limited access to effective screening programs, resistance to chemotherapy and targeted therapies, persisting lymphedema, etc. MBS represents an attractive intervention not only for decreasing the risk of carcinogenesis in high-risk women living with obesity but most importantly as a measure to improve disease-specific and overall survival in patients with diagnosed obesity-related GC. However, well-documented benefits arise only for breast cancer in postmenopausal women, endometrial cancer in premenopausal women, and ovarian cancer. Conclusion Obesity is not merely a risk factor for gynecologic carcinogenesis, but an inherently connected process. In this regard, metabolic bariatric surgery could serve both as a safe and effective means of primary prevention in high-risk patients and as a secondary prevention measure in GC survivors. Disclosures N/A.

Background:Endometriosis is characterized by the presence of endometrial tissue outsidethe uterus. Beyond medical treatment, surgical intervention is also a viableconsideration. However, current guidelines do not clearly indicate whetherlaparoscopic cystectomy, ablative methods (CO2 laser vaporization, plasmaenergy), or sclerotherapy is the preferred option. Methods: We conductedsearches in two databases (PubMed, Europe PMC) to retrieve articles containingthe keywords ‘surgical intervention for Endometrioma, ovarian reserve,pregnancy rates, fertility’, published between January 1, 2000, and December31, 2023. We will include articles presenting information on surgical interventionfor endometrioma and its correlation with infertility parameters. Articlesdescribing conservative treatment will be excluded. Data will be extracted by twoauthors using predefined criteria.

Accumulation of experience with minimally invasive surgery over the last three decades has rendered laparoscopic surgery the mainstay of management for surgical pathology during pregnancy. In the present meta -review, we compiled the available evidence on the safety of laparoscopic and robotic -assisted surgeries during pregnancy, based on relevant systematic reviews (SR) and meta -analyses (MA). A systematic review was performed for articles published until February 2024 in English using PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online) and Google Scholar based on predefined selection and exclusion criteria. We implemented the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines and included SRs and MAs examining women of childbearing age (population) who had undergone laparoscopic surgery or robotic -assisted laparoscopic surgery during pregnancy (intervention). The presence of comparison to open surgery was desirable but not mandatory (comparator). The included studies should necessarily report on fetal loss (outcome), and optionally on other metrics of fetal, maternal, or operative performance. We considered SRs/MAs analyzing randomized trials, observational studies, case reports, and case series (study design). The methodological quality of SRs/MAs not exclusively including case reports and case series was assessed with the Assessment of Multiple Systematic Reviews (AMSTAR) 2 instrument. A total of 1229 articles were screened, of which 78 were potentially eligible. Of these, 33 articles met our inclusion criteria, 18 containing SRs only and 15 SRs with MA. The examined disciplines were laparoscopic appendectomy (10 studies, 30.3%), laparoscopic cerclage for cervical insufficiency (eight studies, 24.2%), adnexal-ovarian laparoscopic surgery (five studies, 15.2%), laparoscopic cholecystectomy and biliary tree exploration (three studies, 9.1%), laparoscopic myomectomy (two studies, 6.1%), and one study each for laparoscopic surgery regarding pancreatic indications, adrenal indications, and bariatric complications (3.0%). The odds ratio/relative risk for fetal loss rate ranged from 01.9, with variable statistical significance depending on the discipline. Twenty-three out of the 33 studies were submitted to quality evaluation with the AMSTAR 2 instrument, with three being of "low quality" (13.0%) and the remaining 20 of "critically low quality" (87.0%). In conclusion, the widespread acceptance of laparoscopic surgery for treating surgical pathology during pregnancy is substantiated by heterogeneous and low -quality evidence. Literature mainly revolves around laparoscopic appendectomy, whereas other disciplines that may commonly arise during pregnancy, such as cholecystectomy and the acute abdomen following bariatric surgery, are underrepresented in the literature. Factors such as anatomical alterations that may affect surgical access, surgeon's expertise, and the biological course of the underlying pathology should be taken into consideration when selecting the appropriate mode of operating during pregnancy.