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Corrêa EL, Cotian LFP, Lourenço JW, Lopes CM, Carvalho DR, Strobel R, Junior OC, Strobel KM, Schaefer JL, Nara EOB. Overview of the Last 71 Years of Metabolic and Bariatric Surgery: Content Analysis and Meta-analysis to Investigate the Topic and Scientific Evolution. Obes Surg 2024; 34:1885-1908. [PMID: 38485892 DOI: 10.1007/s11695-024-07165-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/02/2024] [Accepted: 03/06/2024] [Indexed: 04/20/2024]
Abstract
Obesity is a worldwide epidemic, and bariatric surgery has become increasingly popular due to its effectiveness in treating it. Therefore, understanding this area is of paramount importance. This article aims to provide an understanding of the development of the topic related to procedures, content, data, and status. To achieve this objective, a literature review and a bibliometric analysis were conducted. The methods provided insight into the current state and relevant topics over time. In conclusion, the article provided the identification of the transformation of the research field, initially focused only on physical aspects, to a more complex approach, which also incorporates psychological and social aspects and the correlation between obesity, bariatric surgery, and quality of life.
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Affiliation(s)
- Erica L Corrêa
- Department of Production and Systems Engineering, Pontifical Catholic University of Paraná, Curitiba, 1155, Brazil
| | - Luís F P Cotian
- Department of Production and Systems Engineering, Pontifical Catholic University of Paraná, Curitiba, 1155, Brazil
| | - Jordam W Lourenço
- Department of Production and Systems Engineering, Pontifical Catholic University of Paraná, Curitiba, 1155, Brazil
| | - Caroline M Lopes
- Department of Production and Systems Engineering, Pontifical Catholic University of Paraná, Curitiba, 1155, Brazil
| | - Deborah R Carvalho
- Department of Applied Social Sciences, Pontifical Catholic University of Paraná, Curitiba, 1155, Brazil
| | - Rodrigo Strobel
- Gastrovida: Bariatric and Metabolic Surgical Center, Curitiba, 433, Brazil
| | - Osiris C Junior
- Department of Production and Systems Engineering, Pontifical Catholic University of Paraná, Curitiba, 1155, Brazil
| | - Kamyla M Strobel
- Gastrovida: Bariatric and Metabolic Surgical Center, Curitiba, 433, Brazil
| | - Jones L Schaefer
- Department of Production and Systems Engineering, Pontifical Catholic University of Paraná, Curitiba, 1155, Brazil
| | - Elpídio O B Nara
- Department of Production and Systems Engineering, Pontifical Catholic University of Paraná, Curitiba, 1155, Brazil.
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Bays HE, Fitch A, Cuda S, Gonsahn-Bollie S, Rickey E, Hablutzel J, Coy R, Censani M. Artificial intelligence and obesity management: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2023. OBESITY PILLARS (ONLINE) 2023; 6:100065. [PMID: 37990659 PMCID: PMC10662105 DOI: 10.1016/j.obpill.2023.100065] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) provides clinicians an overview of Artificial Intelligence, focused on the management of patients with obesity. Methods The perspectives of the authors were augmented by scientific support from published citations and integrated with information derived from search engines (i.e., Chrome by Google, Inc) and chatbots (i.e., Chat Generative Pretrained Transformer or Chat GPT). Results Artificial Intelligence (AI) is the technologic acquisition of knowledge and skill by a nonhuman device, that after being initially programmed, has varying degrees of operations autonomous from direct human control, and that performs adaptive output tasks based upon data input learnings. AI has applications regarding medical research, medical practice, and applications relevant to the management of patients with obesity. Chatbots may be useful to obesity medicine clinicians as a source of clinical/scientific information, helpful in writings and publications, as well as beneficial in drafting office or institutional Policies and Procedures and Standard Operating Procedures. AI may facilitate interactive programming related to analyses of body composition imaging, behavior coaching, personal nutritional intervention & physical activity recommendations, predictive modeling to identify patients at risk for obesity-related complications, and aid clinicians in precision medicine. AI can enhance educational programming, such as personalized learning, virtual reality, and intelligent tutoring systems. AI may help augment in-person office operations and telemedicine (e.g., scheduling and remote monitoring of patients). Finally, AI may help identify patterns in datasets related to a medical practice or institution that may be used to assess population health and value-based care delivery (i.e., analytics related to electronic health records). Conclusions AI is contributing to both an evolution and revolution in medical care, including the management of patients with obesity. Challenges of Artificial Intelligence include ethical and legal concerns (e.g., privacy and security), accuracy and reliability, and the potential perpetuation of pervasive systemic biases.
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Affiliation(s)
- Harold Edward Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
| | | | - Suzanne Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway Ste 145, San Antonio, TX, 78218, USA
| | - Sylvia Gonsahn-Bollie
- Embrace You Weight & Wellness, 8705 Colesville Rd Suite 103, Silver Spring, MD, 10, USA
| | - Elario Rickey
- Obesity Medicine Association, 7173 S. Havana St. #600-130, Centennial, CO, 80112, USA
| | - Joan Hablutzel
- Obesity Medicine Association, 7173 S. Havana St. #600-130, Centennial, CO, 80112, USA
| | - Rachel Coy
- Obesity Medicine Association, 7173 S. Havana St. #600-130, Centennial, CO, 80112, USA
| | - Marisa Censani
- Division of Pediatric Endocrinology, Department of Pediatrics, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68th Street, Box 103, New York, NY, 10021, USA
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Lazzati A. Epidemiology of the surgical management of obesity. J Visc Surg 2023; 160:S3-S6. [PMID: 36725453 DOI: 10.1016/j.jviscsurg.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Surgical interventions for obesity have quintupled in the world in 15 years (140,000 in 2003 vs. 720,000 in 2018), however growth has slowed since 2011. This progressive increase varies by country and from 2008 through 2018, 6.5 million people have undergone bariatric surgery. Growth was strongest in the Asia/Pacific region. Belgium is the country performing the most operations per number of inhabitants: (127 operations per 100,000). France is in 7th place with 72 operations per 100,000 and 70% of patients are operated in surgical services that perform more than 100 procedures per year. The sleeve gastrectomy (SG) is the most commonly performed intervention while the adjustable gastric band (AGB) has practically disappeared. Along with the intragastric balloon, novel endoluminal procedures are being evaluated. A real management policy is needed to respond to this evolution of both epidemiology and techniques.
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Affiliation(s)
- A Lazzati
- Intercommunal Hospital Center of Créteil, Paris East Créteil University, 40, avenue de Verdun, 94000 Créteil, France.
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Cost-Effectiveness of Totally Robotic and Conventional Laparoscopic Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis. Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2022.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Is development in bariatric surgery in Germany compatible with international standards? A review of 16 years of data. Updates Surg 2022; 74:1571-1579. [PMID: 35939232 DOI: 10.1007/s13304-022-01349-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022]
Abstract
Bariatric surgery has expanded tremendously internationally over the past decade. In recent years, bariatric surgery has experienced a significant growth in Germany. However, the question arises as to whether this development is in line with international developments or whether there is still room for improvement that could be challenged. 63,990 primary bariatric procedures recorded in the German Bariatric Surgery Registry (GBSR) were analyzed from 2005 to April 2021. The distribution of procedures according to different variants was analyzed and presented. In the last 16 years, 17 different procedures have been performed. The most common surgical procedure was sleeve gastrectomy (SG), followed by Roux-Y gastric bypass (RYGB) (42%). Adjustable gastric banding (AGB) has declined over time, from 23.5% in the first 5 years to 0.2% in recent years. In comparison, omega-loop gastric bypass has increased over the past 5 years (from 0.4% in the first 5 years to 5.9% in the last 5 years). Laparoscopic procedures have accounted for 96.4% of all bariatric surgeries in recent years. The frequency of some procedures has decreased and some bariatric procedures have lost significance. Overall, bariatric surgery in Germany has developed positively compared to the international trend. Nevertheless, there is one area that needs to be optimized: the development of robotic bariatric surgery, which crawls behind in Germany compared to other countries. To establish the technology in bariatric surgery in a timely manner, a balance must be found between cost neutrality and patient-oriented applications.
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Robotic-assisted vertical sleeve gastrectomy in adolescents: Do BMI limits apply? J Pediatr Surg 2022; 57:1158-1161. [PMID: 35148900 DOI: 10.1016/j.jpedsurg.2022.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/22/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Robotic-assisted vertical sleeve gastrectomy (VSG) in adolescent patients has been shown to have comparable outcomes to laparoscopic VSG. Recent data suggests that metabolic and bariatric surgery (performed using robotic and laparoscopic techniques) in patients with BMI ≥ 50 kg/m2 have a higher risk of adverse events compared to those with BMI < 50 kg/m2. The aim of this study was to compare the outcomes of robotic-assisted VSG in adolescents with a BMI above and below 50 kg/m2. METHODS A retrospective analysis of all adolescents undergoing robotic-assisted VSG between January 2014 and December 2020. Subjects were categorized based on preoperative BMI; Group 1 (BMI < 50 kg/m2) or Group 2 (BMI ≥ 50 kg/m2). Data collection included patient demographics, preoperative BMI, total operative time, access time (i.e., total time for port-placement), 30 day complications, and 30 day hospital readmissions. Analysis was performed using chi-square, Fisher's Exact, and student t-test. RESULTS Total of 115 subjects (Group 1 N = 64 and Group 2 N = 51) were included. No differences in age or ethnicity were detected; however, Group 2 had a higher percentage of male patients (27.5% vs. 4.7%, respectively, p = 0.001). Mean operative times (Group 1 = 122.2 min vs. Group 2 = 121.6 min) and access times (Group 1 = 19.1 min vs. Group 2 = 19.7 min) were similar between groups. Thirty day complication rates were similar between groups (p = 0.133); however, there was a higher rate of hospital readmission in Group 1. CONCLUSION While recent data demonstrate an increased likelihood of adverse events occurring among patients with BMI ≥ 50 kg/m2 undergoing robotic surgery, we observed no differences in intraoperative or early postoperative outcomes based on BMI in this robotic-assisted pediatric cohort.
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Rodríguez-Luna MR, Vilallonga R, Roriz-Silva R, Rangarajan M, García Ruiz de Gordejuela A, Caubet E, Gonzalez O, Palermo M, Fort JM, Armengol M. A Comparison of Clinical Outcomes Between Two Different Models of Surgical Robots in Roux-en-Y Gastric Bypass. J Laparoendosc Adv Surg Tech A 2021; 31:969-977. [PMID: 34525316 DOI: 10.1089/lap.2021.0477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: For the past 20 years, robotic surgical systems have been used for the Roux-en-Y gastric bypass (RYGB). The da Vinci Surgical System (Intuitive Surgical, Inc.) has been one of the most used robotic platforms. This study aims to retrospectively compare the performance of two models of surgical robots. Materials and Methods: A retrospective comparative study was conducted from a prospective database including all patients who underwent robotic RYGB (RRYGB) from 2011 to 2020. Results: Of a total of 277 patients included, 134 were in the RRYGB using the da Vinci S™ (RRYGB-S™) group and 143 were in the RRYGB using the da Vinci Xi™ (RRYGB-Xi™) group. The mean operative time in the RRYGB-S and RRYGB-Xi groups was 154 ± 28 and 151 ± 32 minutes, respectively (P = .510). The was no statistically significant difference in terms of intraoperative complications between the groups with regard to positive blue test, bleeding, and failure of stapler line. The readmission rate was higher in the RRGB-S group (14.1%) than in the RRYGB-Xi group (3.4%) (P = .004), and it was mainly due to major complications (P = .003) including pouch and gastrojejunostomy anastomotic leaks (P = .001). The nonsurgical complications were statistically significantly higher in the RRYGB-S group (7.4%) than in the RRYGB-Xi group (2.1%) (P < .05), as well as the surgical complications were higher in the RRYGB-S group (7.5%) than in the RRYGB-Xi group (0%) (P < .001). The mean percentage of the total weight loss at 1 and 2 years of follow-up did not show any statistically significant difference (P = .547). Conclusions: The higher complication rate in the S surgical system might be correlated with the initial learning curve and stressed the need for proper robotic surgical training and accurate strategies when introducing emerging technologies into the surgical practice.
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Affiliation(s)
- María Rita Rodríguez-Luna
- Research Institute against Digestive Cancer, IRCAD, Department of Surgery, Strasbourg, France
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Ramon Vilallonga
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
- ELSAN, Department of Surgery, Clinique St-Michel, Toulon, France
| | - Renato Roriz-Silva
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
- Department of Medicine, Federal University of Rondônia - UNIR, Pôrto Velho, Brazil
- Division of General Surgery, Hospital de Base of Porto Velho, Pôrto Velho, Brazil
| | | | - Amador García Ruiz de Gordejuela
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Enric Caubet
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Oscar Gonzalez
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Mariano Palermo
- Daicim Foundation, Department of Surgery, Training, Research, and Clinical activity in Minimally Invasive Surgery, Buenos Aires, Argentina
| | - José Manuel Fort
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Manel Armengol
- General Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
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Qudah Y, Alhareb A, Barajas-Gamboa JS, Del Gobbo GD, Rodriguez J, Kroh M, Corcelles R. Robotic Revisional Single Anastomosis Duodenoileal Bypass After Sleeve Gastrectomy. J Laparoendosc Adv Surg Tech A 2021; 32:1027-1031. [PMID: 34494890 DOI: 10.1089/lap.2021.0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Single anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) is a metabolic operation emerging as an option for patients with morbid obesity. It is a promising revisional procedure for weight regain or suboptimal weight loss after sleeve gastrectomy (SG). Currently, there is limited literature describing robotic revisional SADI-S. This study describes the safety, feasibility, and early outcomes of robotic revisional SADI-S after previous SG. Methods: This is a retrospective review from May 26 2019 to January 31 2021. Perioperative outcomes were analyzed. Results: A total of 16 patients underwent the procedure. There were 11 females (69%) with a mean age of 39 ± 11 years. Mean body mass index (BMI) was 44.0 ± 5.1 kg/m2 and median ASA was two. Comorbidities included hypertension (25%), hyperlipidemia (19%), and obstructive sleep apnea (13%). Mean interval from primary to revisional surgery among patients was 5.5 ± 1.4 years. Median operative console time was 110 minutes (IQR = 103-137). There were no intraoperative complications. The median hospital stay was 2 days (IQR = 2-3). Perioperative outcomes included no reoperations, perioperative complications, or deaths. There were two (12.5%) emergency department visits for wound checks without infection but no readmissions. At a median follow-up of 4.5 months (IQR = 1-10), patients had a mean BMI of 38.3 ± 7.3 kg/m2 and a mean percent total body weight loss (%TBW) of 12.7%. Conclusions: Initial outcomes suggest that robotic revisional SADI-S after previous SG is feasible and safe. Future studies are needed to evaluate intermediate- and long-term postoperative outcomes.
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Affiliation(s)
- Yaqeen Qudah
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Alia Alhareb
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Juan S Barajas-Gamboa
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Gabriel Diaz Del Gobbo
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - John Rodriguez
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Matthew Kroh
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Ricard Corcelles
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
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Abstract
Significant improvements have been made in bariatric surgery for the past two decades. Thus, early and late complication rates decreased significantly. Thanks to its promising results, robotic surgery is finding increasing use in the field of surgery and the bariatric surgery is one of these areas. Following the first robotic bariatric surgery in 1997, it continues to be performed at increasing rates thanks to the advantages it brings. Robotic surgery offers new opportunities to improve bariatric surgery, thanks to remote control mechanical arms. The three-dimensional (3D) view, together with the precision of movements and the freedom of arms offer new insights into the more difficult surgeries. Hospitals should prepare a good business plan to financially activate robotic surgery, thus, more robotic procedures can be achieved. Among the expressed concerns for the Da Vinci Systems are issues such as the costs, operational times, and lack of tactile feedback. Annual maintenance fees and instrument costs are undoubtedly higher than laparoscopic surgery methods. Robotic surgery is now integrated into obesity surgery, such as sleeve gastrectomy, Roux-en-Y gastric bypass, one anastomosis gastric bypass, biliopancreatic diversion and single anastomosis duodenal switch. It allows for more efficient and ideal anastomosis and exposure in challenging fields. Robotic bariatric surgery is a safe procedure with a short learning curve, outcomes comparable to laparoscopy and other benefits of robotic technology.
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Affiliation(s)
- Mahir Ozmen
- Department of Surgery, School of Medicine, Istinye University, Istanbul, Turkey - .,Liv Hospital, Ankara, Turkey -
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Rodríguez Luna MR, Vilallonga R. RE: "A Review of the Role of Robotics in Bariatric Surgery: Finding Our Future?" by Veilleux et al. (J Laparoendosc Adv Surg Tech A [Epub ahead of print]; DOI 10.1089/lap.2019.0419). J Laparoendosc Adv Surg Tech A 2019; 29:1389-1390. [PMID: 31584317 DOI: 10.1089/lap.2019.0573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- María Rita Rodríguez Luna
- Department of Minimal Invasive Surgery, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.,Endocrine-Metabolic and Bariatric Surgery Unit, Robotic Surgery Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ramon Vilallonga
- Endocrine-Metabolic and Bariatric Surgery Unit, Robotic Surgery Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona, Barcelona, Spain.,ELSAN, Clinique St-Michel, Toulon, France
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