The vegan diet, often known as a plant-rich diet, consists primarily of plant-based meals. This dietary approach may be beneficial to one’s health and the environment and is valuable to the immune system. Plants provide vitamins, minerals, phytochemicals, and antioxidants, components that promote cell survival and immune function, allowing its defensive mechanisms to work effectively. The term “vegan diet” comprises a range of eating patterns that prioritize nutrient-rich foods such as fruits and vegetables, legumes, whole grains, nuts, and seeds. In comparison to omnivorous diets, which are often lower in such products, the vegan diet has been favorably connected with changes in cardiovascular disease (CVD) risk markers such as reduced body mass index (BMI) values, total serum cholesterol, serum glucose, inflammation, and blood pressure. Reduced intake of low-density lipoprotein (LDL), saturated fat, processed meat, and greater consumption of fiber and phytonutrients may improve cardiovascular health. However, vegans have much smaller amounts of nutrients such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), selenium, zinc, iodine, and vitamin B12, compared to non-vegans, which may lead to detrimental cardiovascular effects. This review aims to present the effect of plant-based diets (PBDs), specifically vegan diets, on the cardiovascular system.

Sodium–glucose cotransporter-2 (SGLT-2) inhibitors, also called gliflozins or flozins, are a class of drugs that have been increasingly used in the management of type 2 diabetes mellitus (T2DM) due to their glucose-lowering, cardiovascular (CV), and renal positive effects. However, recent studies suggest that SGLT-2 inhibitors might also have a ketogenic effect, increasing ketone body production. While this can be beneficial for some patients, it may also result in several potential unfavorable effects, such as decreased bone mineral density, infections, and ketoacidosis, among others. Due to the intricate and multifaceted impact caused by SGLT-2 inhibitors, this initially anti-diabetic class of medications has been effectively used to treat both patients with chronic kidney disease (CKD) and those with heart failure (HF). Additionally, their therapeutic potential appears to extend beyond the currently investigated conditions. The objective of this review article is to present a thorough summary of the latest research on the mechanism of action of SGLT-2 inhibitors, their ketogenesis, and their potential synergy with the ketogenic diet for managing diabetes. The article particularly discusses the benefits and risks of combining SGLT-2 inhibitors with the ketogenic diet and their clinical applications and compares them with other anti-diabetic agents in terms of ketogenic effects. It also explores future directions regarding the ketogenic effects of SGLT-2 inhibitors.

Background: Over the years, surgical techniques have evolved, resulting in an abundance of available procedures in the armamentarium of metabolic and bariatric surgeons, and the technology has also advanced in a similar way. Significant steps have been made in stapling technology especially, introducing artificial intelligence (AI) in optimizing this technology for better treatment outcomes. The introduction of AI in stapling technology showed a decrease in potential stapling complications not only in MBS, but also in other (surgical) specialties. Areas Covered: This review will cover the general principles of stapling in surgery, but with an emphasis on both the technical and anatomical considerations. We will also discuss the mechanisms of staplers and potential safety hazards. Finally, we will focus on how AI is integrated in stapling technology, potential pros and cons, and areas for future development of stapling technology and the integration of AI. Conclusions: In metabolic and bariatric surgery, stapling is a technical procedure that requires a comprehensive understanding of the anatomical and physiological characteristics of the target tissue. Variability in tissue thickness, vascularity, elasticity, and mechanical load, compounded by patient-specific factors and intraoperative dynamics, demands constant vigilance and adaptability from the surgeon. The integration of AI and digital technologies offers potential improvements in refining this process. By providing real-time feedback on tissue properties and supporting intraoperative decision-making, these tools can assist surgeons in optimizing staple-line integrity and minimizing complications. The ongoing combination of surgical expertise with intelligent technology may contribute to advancing precision stapling in metabolic and bariatric surgery.

Background and Objective: Upper gastrointestinal (GI) surgery is evolving toward precision and personalization through the integration of robotic platforms, artificial intelligence (AI), and three-dimensional (3D) printing. This narrative review synthesizes current applications, benefits, limitations, and implementation considerations across esophagectomy and gastrectomy, and highlights areas that require further study. Methods: We performed a narrative review of English-language, peer reviewed literature indexed in PubMed, Embase, and Scopus from database inception to September 09, 2025. Eligible designs included randomized and nonrandomized clinical studies, comparative cohorts, case series, meta-analyses, systematic and narrative reviews, and relevant technical reports in adults. We excluded preprints, non-English articles, conference abstracts without full text, animal-only studies, and single-patient image reports. Outcomes of interest were perioperative results, oncologic quality, workflow and ergonomics, training, cost, and feasibility. Given heterogeneity in designs and endpoints, a narrative synthesis was used. Key Content and Findings: Robotic gastrectomy (RG) is associated with fewer conversions to open surgery, lower overall complication rates, and small reductions in intraoperative blood loss, while long-term survival appears comparable to laparoscopy. In esophagectomy, robotic-assisted minimally invasive approaches report lower recurrent laryngeal nerve palsy, and operative time improves as programs gain experience. AI supports early lesion detection, perioperative risk stratification, and intraoperative guidance in upper GI practice. Patient-specific 3D models enhance preoperative planning, team rehearsal, and communication, and early bioprinting studies indicate potential future reconstructive applications. Adoption is shaped by costs, training requirements, information-technology integration, regulation, and equitable access. Conclusions: The combined use of robotics, AI, and 3D printing supports a shift toward minimally invasive, data-enabled, and patient-specific upper GI surgery. Current evidence suggests gains in safety, efficiency, and planning, while several applications, particularly advanced AI and bioprinting, require prospective validation and standardized implementation.

Metabolic and bariatric surgery (MBS) remains the most effective treatment for severe obesity and metabolic comorbidities, offering durable weight loss and superior outcomes compared with non-surgical approaches. However, despite operative refinements, enhanced recovery pathways, and perioperative optimization, complications can arise early or years postoperatively. These range from anastomotic leaks, intraluminal bleeding, strictures, marginal ulcers, perforations, and fistulas to functional disorders such as dumping syndrome and recurrent weight gain (RWG). Managing these challenges requires prompt diagnosis, multidisciplinary evaluation, and a stepwise, individualized treatment strategy. Endobariatric therapy has emerged as a vital component of bariatric care, serving both as a primary metabolic intervention and as an effective rescue platform. Modern therapeutic endoscopic techniques, including tissue apposition systems, pneumatic dilation, septotomy, stricture disruption, fully covered self-expanding metal stents (SEMS), over-the-scope clips (OTSC), endoscopic internal drainage (EID), transoral outlet reduction (TORe), endoscopic sleeve revision, and endoluminal remodeling, provide high precision, safety, and durability, often preserving altered anatomy while averting morbid revisional surgery. This chapter reviews current evidence, rescue maneuvers, and clinical protocols for managing post-MBS complications, emphasizing treatment sequencing, candidate selection, and decision-making in high-risk patients. Furthermore, it highlights the expanding role of artificial intelligence (AI), robotic-assisted endoscopy, standardized staging pathways, and predictive modeling in enhancing procedural planning, durability, and safety. As these innovations advance, endobariatrics is transitioning from an adjunct modality to a fundamental pillar of comprehensive bariatric practice, redefining modern standards of care.