Artificial intelligence (AI) is revolutionizing the landscape of metabolic and bariatric surgery (MBS), a field that involves weight loss procedures designed to help obese patients achieve lasting health benefits. A recent expert consensus study aimed at charting the future of AI in MBS has brought together insights from 68 leading surgeons from 35 countries, marking a significant collective step toward integrating AI technologies responsibly in surgical practices.
The study, which spanned two rounds of voting conducted via a modified Delphi method, sought to explore the potential roles of AI in enhancing educational processes, decision-making, and patient outcomes in MBS. The first voting phase, held from December 16 to December 29, 2024, achieved consensus on 25 out of 28 proposed statements, with the remaining three reaching agreement in the second round from January 11 to January 25, 2025.
Consensus revealed that one of AI's most promising roles lies in its ability to provide objective evaluations of surgical skills, enabling more personalized feedback for trainees and thereby accelerating their learning curves. The consensus study emphasized, "AI has the potential to enhance the evaluation of surgical skills in MBS by providing objective, detailed assessments, enabling personalized feedback, and accelerating the learning curve," as noted by the authors of the article.
Additionally, the expert panel recognized AI's promising capabilities in facilitating patient selection and surgical planning. Experts agreed that AI can assist in identifying qualified candidates for MBS referrals, helping patient and procedure selection, and addressing specific clinical questions. "Experts agreed that AI can assist in identifying qualified candidates for MBS referrals, helping patient and procedure selection, and addressing specific clinical questions," the authors highlighted.
However, the reliance on AI systems also raises ethical considerations, a point raised throughout the consensus discussions. The need to establish robust ethical guidelines governing AI's use was emphasized, alongside an unequivocal commitment to include AI's role in the patient consent process. The necessity for transparent communication around AI capabilities was underscored, as feedback revealed apprehensions about potential over-reliance on technology at the expense of human skills.
Another pivotal recommendation from the expert consensus was the integration of AI education into surgical training programs. Panelists acknowledged that education about AI technologies is critical for future surgeons, signaling a shift in how surgical training frameworks should evolve. "AI education should become an essential component of future surgical training," underscored the authors.
The discussion of AI in MBS also delved into its applications beyond surgical practice. Innovations in AI-assisted technology, such as virtual reality (VR) and augmented reality (AR), are expected to reshape surgical education positively, aiding in skill development while minimizing risks. As outlined, "Experts reached a consensus that AI could enhance the quality of training, optimize faculty time, and expand the educational capacity of institutions, streamlining bariatric surgical education."
AI’s role extends to predicting clinical outcomes as well, with consensus indicating that AI can be invaluable in estimating post-operative complications, weight loss trajectories, and the likelihood of remission from obesity-related medical conditions. Leveraging large, diverse patient datasets, AI algorithms can identify patterns and predictors that are crucial for tailored patient care. The potential of AI-powered wearable devices for monitoring patients post-surgery was also recognized as a promising advancement in improving patient engagement and adherence to recovery protocols.
Despite the advantages, the expert consensus sounds a cautious note about the changing landscape of healthcare due to AI integration. There are growing concerns about the impact of these technologies on patient-provider relationships. Trust, accountability, and the human element in care emerged as crucial factors in how AI will be received in clinical settings. As one of the authors articulated, "The consensus emphasized the need for ethical guidelines governing AI use and the inclusion of AI's role in decision-making within the patient consent process."
In conclusion, this global expert consensus on the current status and future prospects of AI in metabolic and bariatric surgery highlights an optimistic, yet cautious, perspective on integrating advanced AI technologies in surgical practices. With careful implementation, robust education, and clear ethical guidelines, AI has the potential to revolutionize practices in MBS, enhance patient outcomes, and redefine the surgeon's role in a technology-driven future.