THE TRANSFORMATIVE IMPACT OF ARTIFICIAL INTELLIGENCE ON BARIATRIC SURGERY: ENHANCING PATIENT OUTCOMES, SURGICAL PRECISION, AND POSTOPERATIVE CARE

: Bariatric surgery has become a leading intervention for severe obesity, markedly improving weight loss, resolving comorbidities, and enhancing quality of life. However, the complexity of these procedures necessitates comprehensive patient management to optimize outcomes. Recent artificial intelligence (AI) advancements present innovative solutions that can significantly transform bariatric surgery. This narrative review examines the potential of AI to enhance patient outcomes, improve surgical precision, and streamline postoperative care, highlighting its role in revolutionizing bariatric practices and addressing the challenges faced in this field.


INTRODUCTION
Bariatric surgery has emerged as an effective treatment for severe obesity, offering significant improvements in weight loss, comorbidity resolution, and overall quality of life.
However, the complexity of these procedures and the need for comprehensive patient care have driven the search for innovative solutions to optimize surgical outcomes and postoperative management.In recent years, artificial intelligence (AI) has shown remarkable potential to revolutionize various aspects of healthcare, including bariatric surgery.This narrative review aims to inspire and explore the transformative impact of AI on bariatric 1 UniRV -FAMERV (Campus Rio Verde). 2 Centro universitário do Pará -CESUPA. 3Faculdade de Medicina de Itajubá. 4 Santa Casa de Misericórdia de Vitoria Higher School of Sciences -EMESCAM Santa Luíza -Vitória -ES -Brazil.Molecular Dynamics and Modeling Laboratory (DynMolLab). 5Molecular Dynamics and Modeling Laboratory (DynMolLab) Santa Luíza -Vitória -ES -Brazil.surgery, focusing on its applications in enhancing patient outcomes, surgical precision, and postoperative care.

METHODOLOGY
A comprehensive literature search was conducted using major databases, including Scopus, Web of Science, PubMed, ScienceDirect, and IEEE Xplore.The search terms included combinations of "artificial intelligence," "machine learning," "deep learning," "bariatric surgery," "obesity surgery," "patient outcomes," "surgical precision," and "postoperative care." Relevant articles published in English between 2018 and 2024 were selected for review.The identified studies were critically appraised for their methodological quality and relevance.The findings were synthesized and organized into thematic sections to provide a comprehensive overview of the current state of AI applications in bariatric surgery.AI integration with wearable devices and telemedicine platforms allows for continuous remote monitoring of patients after discharge, facilitating early detection of complications and reducing the need for readmissions (Feinstein et al., 2024).These advancements collectively contribute to better patient outcomes, shorter hospital stays, and more efficient healthcare delivery.

Challenges and Ethical Considerations
While AI offers numerous benefits in bariatric surgery, it also presents challenges and ethical considerations that must be addressed.False positives and alert fatigue are potential side effects of AI-driven monitoring systems, which can lead to important alerts (Aasvang & Meyhoff, 2023).Data privacy and security concerns arise from collecting and analyzing large amounts of patient data, necessitating robust measures to protect patient information (Kavian et al., 2023).Algorithmic bias is another challenge, as AI algorithms can inherit biases present in the training data, potentially leading to disparities in care (Kavian et   al., 2023).Moreover, there is a risk of over-reliance on technology, which may undermine clinical judgment if not correctly balanced (Lu et al., 2023).Addressing these challenges through rigorous testing, ethical guidelines, and continuous monitoring is crucial for AI's practical and responsible integration in bariatric surgery.

DISCUSSION
This narrative review's findings highlight AI's transformative potential in enhancing patient outcomes, surgical precision, and postoperative care in bariatric surgery.AI-assisted patient selection and risk assessment models enable personalized surgical planning and informed decision-making, improving surgical outcomes and reducing complication rates Patient Selection and Risk Assessment AI's Potential in Patient Selection and Risk Assessment for Bariatric Surgery AI has demonstrated its potential to revolutionize patient selection and risk assessment for bariatric surgery.Machine learning algorithms can sift through vast datasets, including electronic health records, imaging data, and patient-reported outcomes, to forecast surgical outcomes and pinpoint patients at higher risk for complications (Bellini et al., 2022; Hassan et al., 2023).For instance, Bellini et al. (2022) engineered an AI model that accurately predicted postoperative complications with an area under the receiver operating characteristic curve (AUC) of 0.98.These predictive models contribute to precision medicine by tailoring surgical plans to individual patient profiles, enabling informed decision-making and personalized risk stratification.Enhancing Surgical Precision with AI Intraoperative AI technologies, such as computer vision and robotic assistance, have shown remarkable potential in enhancing surgical precision and efficiency.Computer vision models can analyze surgical videos in real time, automatically identifying critical steps and safety milestones during procedures like sleeve gastrectomy (Dayan, 2024; Hashimoto et al., 2019).Dayan (2024) implemented an AI-based computer vision model for sleeve gastrectomy, demonstrating high accuracy in annotating safety milestones, contributing to standardized procedures, and reducing intraoperative complications.This emphasis on AI's role in enhancing surgical precision should reassure the audience about the safety and effectiveness of bariatric surgery.AI-Driven Postoperative Monitoring and Complication Prediction Postoperative care is a critical aspect of bariatric surgery, and AI has shown significant potential in optimizing recovery protocols and predicting complications.AI-driven models can analyze postoperative data to identify patients at risk for complications, enabling timely interventions and personalized recovery plans (Bellini et al., 2022; Bektaş et al., 2022).For example, Ren et al. (2022) developed a machine learning algorithm that accurately predicted postoperative complications using electronic health record data, with the predictions accessible to surgeons via a mobile platform.This real-time predictive analytics enhances clinical decision-making and resource allocation, ultimately improving patient outcomes and reducing hospital stays and readmissions.Long-Term Benefits of AI Integration in Postoperative Care The Long-Term Gains of AI Integration in Postoperative Care the long-term benefits of AI integration in postoperative care for bariatric patients are substantial and multifaceted.AI-driven continuous vital sign monitoring (CVSM) systems can identify deviations in patient vitals more effectively than manual intermittent monitoring, enabling early detection of complications and timely interventions (Aasvang & Meyhoff, 2023).Moreover, AI algorithms can personalize recovery protocols based on individual patient risk factors, optimizing resource allocation and improving outcomes (Bellini et al., 2022; Bektaş et al., 2022).

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Bellini et al., 2022; Hassan et al., 2023).Intraoperative AI technologies, such as computer vision and robotic assistance, enhance surgical precision and efficiency, ultimately leading to better patient outcomes(Dayan, 2024; Hashimoto et al., 2019; Shinohara, 2023).AI-driven postoperative monitoring and complication prediction models facilitate early detection of complications, personalized recovery plans, and timely interventions, resulting in shorter hospital stays and reduced readmissions(Bellini et al., 2022; Bektaş et al., 2022; Ren et al., 2022).This emphasis on the potential of AI to improve patient outcomes should make the audience feel hopeful and positive about the future of bariatric surgery.The long-term benefits of AI integration in postoperative care are substantial, including early detection of complications, personalized recovery protocols, reduced hospital stays and readmissions, enhanced remote monitoring, and improved clinical decision support (Aasvang & Meyhoff, 2023; Bellini et al., 2022; Bektaş et al., 2022; Feinstein et al., 2024).These advancements collectively contribute to better patient outcomes and more efficient healthcare delivery.However, the integration of AI in bariatric surgery also presents challenges and ethical considerations, such as false positives, data privacy concerns, algorithmic bias, overreliance on technology, and implementation issues (Aasvang & Meyhoff, 2023; Kavian et al., 2023; Lu et al., 2023).Addressing these challenges through rigorous testing, ethical guidelines, and continuous monitoring is essential for AI's practical and responsible integration into clinical practice.The findings of this review align with the growing body of evidence supporting the transformative potential of AI in healthcare.The application of AI in bariatric surgery is a prime example of how this technology can enhance patient care, optimize surgical outcomes, and improve overall healthcare delivery.As AI continues to evolve and mature, healthcare professionals must stay informed about its advancements and actively engage in developing and implementing AI-driven solutions.Collaborative efforts between clinicians, researchers, and AI experts are necessary to ensure AI's ethical and effective integration in bariatric surgery and other medical specialties.CONCLUSIONThis narrative review demonstrates the transformative impact of AI on bariatric surgery, highlighting its potential to enhance patient outcomes, surgical precision, and postoperative care.AI-assisted patient selection, risk assessment, intraoperative technologies, and postoperative monitoring models contribute to personalized surgical planning, reduced complication rates, early detection of complications, and optimized recovery protocols.The long-term benefits of AI integration in postoperative care include improved patient outcomes, shorter hospital stays, reduced readmissions, and more efficient healthcare delivery.However, challenges and ethical considerations, such as false positives, data privacy concerns, algorithmic bias, and over-reliance on technology, must be addressed through rigorous testing, ethical guidelines, and continuous monitoring.As AI advances, collaborative efforts between clinicians, researchers, and AI experts are essential for the responsible and effective integration of this technology in bariatric surgery and beyond.Future research should focus on developing robust AI models, validating their clinical effectiveness, and exploring novel applications to enhance patient care and surgical outcomes in bariatric surgery.