In 2025, digestive surgery is evolving with the integration of pharmacology and immunotherapy. In severe obesity, surgery remains the most durable option, while GLP-1 and GLP-1/GIP agonists provide an effective complement but require long-term treatment. In liver cancer, immunotherapy expands access to curative surgery through improved tumor control. For locally advanced colon cancer, neoadjuvant chemotherapy and MMR status guide decisions, with immunotherapy becoming key in dMMR cases. These advances highlight the importance of coordinated care and the central role of general practitioners.