DOI: 10.20452/wiitm.2025.17950, Published online: May 09, 2025, Authors: Piotr Major¹, Michał Orłowski², Piotr Małczak¹, Natalia Dowgiałło-Gornowicz³, Artur Binda⁴, Paweł Bogdański⁵, Andrzej Budzyński⁶, Dorota Budzyńska⁶, Michał Janik⁷, Paweł Jaworski⁴, Krzysztof Kaseja⁸, Łukasz Kaska⁹, Bartosz Katkowski¹⁰, Tomasz Koszutski¹¹, Grzegorz Kowalski¹², Dominika Krakowczyk¹¹, Andrzej Kwiatkowski¹³, Paweł Lech³, Tomasz Lewandowski¹⁴, Wojciech Lisik¹⁵, Wojciech Makarewicz^16,17, Maciej Matyja¹, Wojciech Milanowski¹⁸, Rafał Mulek¹⁹, Piotr Myśliwiec²⁰, Lucyna Ostrowska²¹, Maciej Pastuszka²², Krzysztof Paśnik²³, Michał Pędziwiatr¹, Monika Proczko-Stepaniak²⁴, Hady Razak Hady²⁵, Tomasz Rogula²⁶, Anna Różańska-Walędziak²⁷, Jerzy Sieńko²⁸, Jacek Sobocki²⁹, Michał Spychalski^30,31, Jacek Szeliga²³, Tomasz Szewczyk³², Michał Szymański²⁴, Paweł Szymański¹⁰, Wiesław Tarnowski⁴, Maciej Walędziak¹³, Mateusz Wityk³³, Mariusz Wyleżoł³⁴, Michał Wysocki⁶

Purpose: This review aims to explore and summarise current knowledge of indocyanine green (ICG) fluorescence application in metabolic and bariatric surgery (MBS) and assess its potential in improving patient safety. Methods: The review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Evidence from PubMed, ScienceDirect and Ovid MEDLINE databases was independently screened in October 2022. The primary information and outcomes were the type of fluorescence application with potential patient benefit and the complication rate. The secondary outcomes consisted of the kind of dye, the application protocol, and the equipment used. Results: Thirteen publications were included, with six prospective observational studies, five case reports and two retrospective cohort studies and involved a total of 424 patients. The publications were categorized into four groups based on the method of fluorescence application. Sixty-six percent of the cases used fluorescence for LSG, 32.3% used it for RYGB, 1.2% for revisional surgery, 0.2% during removal of an adjustable gastric band, and 0.2% for LSG combined with Rossetti fundoplication. ICG was used on its own in the majority of studies, although in one case, it was used in combination with methylene blue. ICG administration protocols varied significantly. Complications occurred in three patients (0.71%): leaks were diagnosed in two cases, and one patient required a blood transfusion. Conclusion: The most popular type of use is intraoperative assessment of the blood supply. ICG application may reduce the risk of complications, with potential benefits in detecting ischemia and leaks, searching for bleeding in areas inaccessible to endoscopy, and non-invasive hepatopathy evaluation.

Background Sleeve gastrectomy (SG) is currently the most frequently performed bariatric procedure worldwide. While its popularity continues to grow due to favorable surgical outcomes and acceptable complication rates, maintaining long-term postoperative follow-up remains a major challenge. This study aimed to identify factors influencing adherence to 10-year follow-up in patients who underwent SG and to evaluate their long-term clinical outcomes. Methods A retrospective analysis was conducted on 150 patients who underwent SG between 2013 and 2014 at a single center in Poland. Data included demographics, obesity-related diseases, surgical details, and follow-up adherence. Logistic regression was used to identify predictors of long-term follow-up. Outcomes such as weight loss, obesity-related diseases remission, and surgical complications were assessed in accordance with ASMBS guidelines. Results Of 150 patients, 101 (67.3%) completed the 10-year follow-up. Age was the only independent predictor of long-term follow-up adherence (OR = 1.03, CI = 1.00–1.07, p = 0.048). Neither distance from the hospital nor size of the city of residence significantly impacted follow-up rates. Among the patients with follow-up, the median total weight loss (%TWL) was 21.5%, and remission of type 2 diabetes and hypertension occurred in 55.6% and 36.8% of patients, respectively. Additional surgery was performed in 16 patients, mainly due to recurrent weight gain and gastroesophageal reflux disease. Complication rate was 4.0%, with no mortality reported. Conclusions Older patients had slightly higher follow-up adherence after SG. Despite multiple measures to maintain contact, a substantial proportion of patients were lost to follow-up.

Quality of life after laparoscopic sleeve gastrectomy – review of literature. Background The last decade brought changes the most frequently performed types of bariatric procedures. Despite the well-documented positive impac...

DOI: 10.20452/wiitm.2024.17912, Published online: November 19, 2024, Authors: Mateusz Wityk¹, Maciej Bobowicz², Mateusz Pryt³, Natalia Dowgiałło-Gornowicz⁴

The rising prevalence of obesity among the elderly poses unique challenges. While life expectancy has improved due to advancements in medical care, this increase in longevity does not necessarily correlate with an improved quality of life. Instead, the obesity epidemic, particularly in the later decades of life, is linked to a heightened demand for healthcare services and higher healthcare costs. This study aimed to analyze bariatric surgeons' perspectives on the role of anti-obesity medications (AOMs) in metabolic bariatric surgery (MBS) for patients over 65, focusing on treatment preferences in clinical scenarios. Additionally, an obesity treatment algorithm for older patients was proposed. A survey was conducted among bariatric surgeons worldwide from September to October 2024, including questions on demographics, experience, and clinical scenarios. A questionnaire specifically designed for the purposes of this study was used. Of 184 respondents from 53 countries, 77.2% reported prescribing AOMs. Sleeve gastrectomy is most preferred as the primary surgical option for patients over 65. Treatment preferences varied by BMI, with AOMs favored for a BMI of 30-35 kg/m², and MBS preferred for higher BMIs. This study highlights the integration of AOMs into obesity management for older adults, with sleeve gastrectomy as the primary surgical choice. Treatment choices were consistent across surgeon demographics, underscoring the need for tailored approaches in elderly obesity care.