Background: Robotic sleeve gastrectomy (RSG) is gaining adoption in metabolic bariatric surgery, yet evidence on its perioperative safety, efficiency, and costs during the early learning phase remains limited. Objectives: To evaluate outcomes, learning curve dynamics, and procedural costs for totally robotic sleeve gastrectomy. Setting: Academic center. Methods: A retrospective analysis was conducted of the first 53 consecutive RSGs (April 2023–July 2025) performed by a single surgeon using a standardized fully robotic technique. Perioperative variables, 30-day morbidity, and cost data were collected. Learning curves for docking time, console time, and total operative time were assessed using Cumulative Sum (CUSUM) analysis. Results: Mean age and BMI were 38.1 ± 12.6 years and 41.6 ± 6.3 kg/m ² , respectively; 71.7% were female. Overall complication rate was 7.5% (3 bleedings, 1 leak) with no mortality or reinterventions. ICU admission and readmission each occurred in 1.9% of cases. Mean docking time was 17.8 ± 9.4 min, console time 51.5 ± 17.0 min, and total operative time 69.3 ± 18.1 min. The mean length of stay was 3.6 ± 1.1 days (range 2–10). CUSUM identified proficiency points at case 18 for docking time (− 51.1%), case 23 for console time (− 18.6%), and case 22 for total operative time (− 21.5%). Median length of stay was 3 days. Mean direct instrument/stapling cost per RSG was €4,535. Conclusions: Totally RSG can be introduced with safe outcomes even during the learning phase. Proficiency for operative efficiency was reached after 20 cases. Graphical

Background: The aim of this study was to evaluate the performance of the diagnostic pathway proposed by the European Society of Cardiology (ESC) guidelines for identifying the underlying aetiology of sudden cardiac death (SCD) through the screening of first-degree family members of patients with SCD who either had a negative autopsy or no autopsy performed. Methods: To be eligible for enrolment, patients had to meet the following inclusion criteria: a family history of SCD in a first-degree relative under the age of 50 years; the SCD decedents must not have undergone an autopsy, or if an autopsy was performed, non-cardiac and structural cardiac causes must have been excluded. Patients underwent a comprehensive assessment, including the evaluation of family and medical history, electrocardiography (ECG) and ECG with high precordial leads, Holter ECG monitoring, echocardiography, cardiac magnetic resonance imaging, and exercise stress testing. A sodium channel blocker test (i.e., flecainide test) was performed when other clinical investigations were negative and the suspicion of Brugada syndrome was high. Results: Forty-one patients from 25 different families fulfilled the inclusion criteria and represented the final study cohort. After the comprehensive diagnostic work-up, a total of seven patients from five different families (5/25, 20%) were diagnosed with an inherited cardiac condition: two families with arrhythmogenic right ventricular cardiomyopathy, one with dilated cardiomyopathy, one with non-dilated left ventricular cardiomyopathy, and one with long QT syndrome. Conclusions: The comprehensive cardiologic work-up of relatives of mainly young SCD victims results in the diagnosis of inherited cardiac conditions in one-fifth of cases.