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Bariatric Challenges: Dr. Sharique Nazir’s Strategic Insights from WALS 2025 The field of bariatric surgery is at a pivotal moment, with rising obesity rates worldwide driving demand for innovative, effective, and safe interventions. At the World Association of Laparoscopic Surgeons (WALS) 2025 conference, held on February 8-9 at the luxurious Leela Ambience Gurugram in India, Dr. Sharique Nazir, a globally recognized leader in robotic and bariatric surgery, shared his strategic insights into the evolving challenges and opportunities in this specialized domain. As the Chief of Bariatric & Robotic Surgery at NYC Health + Hospitals/Harlem and the incoming 2025 President of the International College of Surgeons (US Section), Dr. Nazir brought a wealth of experience and a forward-thinking perspective to the discussion. The Growing Burden of Obesity and Bariatric Surgery’s Role Obesity remains a pressing global health crisis, linked to conditions like diabetes, hypertension, and cardiovascular disease. Dr. Nazir emphasized that bariatric surgery has transcended its initial role as a weight-loss tool, emerging as a critical intervention for metabolic health. However, the increasing prevalence of super-super obesity (BMI > 60 kg/m²) and complex revisional cases presents unique challenges. These patients often face higher surgical risks, technical difficulties, and a greater need for personalized approaches—issues that dominated his address at WALS 2025. Drawing from his extensive experience in New York City, where he has performed countless laparoscopic and robotic procedures, Dr. Nazir highlighted how advanced minimally invasive techniques are transforming outcomes. “The future of bariatric surgery lies in precision, safety, and accessibility,” he noted, underscoring the need to adapt to a diverse and increasingly complex patient population. Technical Challenges in Modern Bariatric Surgery One of the key challenges Dr. Nazir addressed was the technical complexity of operating on patients with extreme obesity or those requiring revisional surgery due to prior procedure failures. Laparoscopic techniques, while revolutionary, can be limited in such cases due to restricted visibility and maneuverability. Here, he championed the integration of robotic surgery, which offers enhanced 3D visualization, greater dexterity, and multi-quadrant access without repositioning—advantages he has leveraged in his practice. He cited examples from his own work, such as sleeve gastrectomy and Roux-en-Y gastric bypass, where robotic platforms have reduced operative times and complications, particularly in high-BMI patients. However, he cautioned that the learning curve for robotic surgery remains steep, and its higher costs pose barriers to widespread adoption—a challenge that WALS 2025 attendees discussed at length. Strategic Insights for Overcoming Barriers Dr. Nazir’s strategic insights focused on three pillars: innovation, education, and collaboration. First, he advocated for continued advancements in surgical technology, such as next-generation robotic systems and improved stapling devices, to enhance safety and efficacy. He pointed to emerging data showing robotic approaches reducing hospital stays and postoperative discomfort, aligning with patient-centered care goals. Second, education emerged as a cornerstone of his strategy. With bariatric surgery’s rapid evolution, training programs must evolve too. Dr. Nazir, an Assistant Professor at Columbia University Irving Medical Center, stressed the importance of equipping surgeons with hands-on experience in both laparoscopic and robotic techniques. He praised WALS 2025’s workshops, which offered practical training, as a model for global skill-building. Finally, he called for greater collaboration among surgeons, researchers, and policymakers to address systemic challenges like access to care. In regions like India, where obesity is rising but bariatric surgery remains underutilized, he urged the development of high-quality centers of excellence, a model he has helped implement in the U.S. His multilingual fluency—speaking Urdu, Hindi, and Russian—underscored his commitment to bridging cultural and geographic divides in surgical practice. Conclusion Dr. Sharique Nazir’s strategic insights at WALS 2025 illuminated the multifaceted challenges of bariatric surgery—from technical hurdles to systemic barriers—while offering a roadmap for progress. By blending cutting-edge technology with education and collaboration, he envisions a future where bariatric surgery not only saves lives but transforms them. For the surgeons gathered in Gurugram, his message was clear: the fight against obesity demands innovation, expertise, and a relentless commitment to patient care—values he embodies in his remarkable career.