We thank Gilles Mithieux and Aude Barataud (INSERM U1213, Lyon, France) and Marie Liabeuf and Stephanie Lemarchand-Minde (Animal facility, l'Institut du Thorax, Nantes, France) for their help with the animal care protocol. This work was supported by grants from La r&#233;gion des Pays de la Loire, the Fondation d'Avenir, and the Casden Bank. We would like to thank Catherine Postic, Fadila Benhamed and Michelle Ca&#252;zac from l'institut Cochin for their hospitality and their help during the filming process.

Animali e delle abitazioni: Ottenere 8 settimane di età topi maschi C57BL / 6. A 10 settimane, dare il topi C57BL / 6 libero accesso all&#39;acqua e una dieta ricca di grassi (DIO dieta: il 35% kcal dai grassi, 25,8% caseina, 1,30% AIN minerale, 1,30% vitamine, 1,70% fosfato bicalcico, 0,7 carbonato% di calcio, 2,10% di potassio citrato, 0,026% bitartrato di colina, 8,9% di saccarosio, 0,384% cistina, 6,5% di cellulosa, 31,7% strutto, olio di soia 3,3%, e il 16.29% maltodestrina) per 8 (SG) o 14 (RYGB) settimane prima della chirurgia bariatrica. Per promuovere l&#39;aumento di peso, invia i topi dedicato alla chirurgia RYGB (sham &amp; RYGB) acqua contenente il 20% di fruttosio (w / v) in aggiunta alla dieta ad alta percentuale di grassi. Etica Dichiarazione: Tutti i passaggi protocollo descritto di seguito seguire le linee guida del Comitato Etico per la Sperimentazione Animale di Pays de la Loire con il numero di omologazione 01.953,01. 1. Generale preoperatoria Preparazione <ol><li> Digiunare i topi per 6 ore prima della chirurgia. Gel diet il cibo è stato dato 3 giorni prima dell&#39;intervento chirurgico ed esclusivamente un giorno prima dell&#39;intervento. Indurre anestesia in una camera con 5% isoflurano (0,4 L / min) e O 2 (dioxygen; 0,4 L / min). Eseguire un test in punta pinch per confermare che l&#39;anestesia è efficace. Somministrare analgesici (0,1 mg / kg buprenorfina), antibiotici (10 mg / kg marbofloxacine), e pro-cinetiche (1 mg / kg metoclopramide) tramite iniezioni sottocutanee. </li><li> Allocare un&#39;area di lavoro specifica per le procedure chirurgiche (lontani dai fan di traffico di laboratorio e di ventilazione). Pulire l&#39;area chirurgica con disinfettanti per superfici dure dedicate. Posizionare una piastra elettrica sulla zona di spazio di lavoro per mantenere omeotermia mouse durante l&#39;intervento chirurgico. Applicare una underpad pulito, assorbente il rilievo di riscaldamento. </li><li> Shave l&#39;addome da sterno alla pelvi con un rasoio elettrico. Avvolgere l&#39;addome del mouse in sterilizzato involucro di plastica (Figure 1A e 2A) e posizionare il mouse in posizione supina sul riscaldamento panno Domini. </li><li> Applicare veterinario pomata per gli occhi per prevenire la secchezza mentre sotto anestesia. Posizionare il mouse nel cono di naso e mantenere l&#39;anestesia con il 2% isoflurano (0,4 l / min) e O 2 (0,4 l / min). </li><li> Prima di iniziare l&#39;intervento, messo su un camice sterile esame, un berretto scrub usa e getta, una maschera e guanti sterili. Aprire un pacchetto autoclave contenente una serie strumento chirurgico sterilizzata, che è richiesto per tutte le fasi della chirurgia. Tagliare una finestra nella pellicola trasparente sterilizzato e disinfettare la pelle con 2 soluzioni povidone-iodio successive. </li></ol> 2. Sleeve gastrectomy: Procedura chirurgica <ol><li> Laparotomia mediana (Figura 1B) <ol><li> Sotto un microscopio binoculare e con un bisturi, effettuare un&#39;incisione mediana da sterno al centro dell&#39;addome per aprire la cavità addominale (non danneggiare i muscoli addominali). Proteggere la pelle con un impacco sterile imbevuta di 37 ° C una soluzione salina. </li></ol></li><li> L&#39;esposizione dello stomaco (Figura 1C) <ol><li> mobilitare delicatamente lo stomaco utilizzando tamponi di cotone inumidito-. Liberare lo stomaco dai suoi stretti allegati del tessuto connettivo laterali utilizzando tamponi di cotone inumiditi o forbici micro. </li><li> Delicatamente, esternare lo stomaco pieno e posizionare un collagene emostatico comprimere dietro lo stomaco. Suturare il piloro e vasi esofago lungo la grande curvatura dello stomaco con 8,0 punti di sutura non assorbibili per evitare futuro sanguinamento (Figura 1D ed E). Nota: l&#39;uso Hemostat può indurre danni ai tessuti, assicurarsi di utilizzare solo su tessuto che mirano a essere asportato. </li></ol></li><li> Resezione della regione cardiaca dello stomaco (fondo) <ol><li> Eseguire un gastrotomia sulla linea anatomica presente tra la regione pilorica (corpo) e la regione cardiaca dello stomaco (fondo) (Figura 1F). </li><li> Rimuovere residui di cibo con 2 tamponi di cotone inumiditi verso ognilato dello stomaco. Utilizzando le forbici micro, tagliare lo stomaco lungo il confine tra il fondo e il corpus dello stomaco (Figura 1G). </li><li> Premere un collagene emostatico comprimere per 2 minuti in caso di sanguinamento maggiore. Chiudere il foro stomaco con 8,0 punti di sutura non assorbibili dalla giunzione gastroesofageo alla fine dell&#39;incisione (Figura 1H). </li></ol></li><li> Resezione della regione pilorica dello stomaco (corpo) <ol><li> Completa resezione dello stomaco lungo la grande curvatura in modo da rimuovere circa il 80% dello stomaco (Figura 1I). Standardizzare la larghezza della SG a 3 mm. Premere un collagene emostatico comprimere per 2 minuti in caso di sanguinamento maggiore. </li><li> Chiudere l&#39;apertura della regione pilorica dello stomaco con 8,0 sutura non riassorbibile (Figura 1J). Ruotare delicatamente 2 tamponi di cotone inumiditi verso ogni lato dello stomaco per garantire che la sutura è a tenuta stagna. </li><li>Completare con 8,0 punti di sutura non assorbibili in caso di perdite. Rimuovere le compresse di collagene emostatici e tornare lo stomaco alla cavità addominale. Lascia un collagene emostatico comprimere contro la sutura. </li></ol></li><li> chiusura addominale <ol><li> Chiudere lo strato muscolare della parete addominale con 5.0 punti di sutura non assorbibili (Figura 1K). Ridurre anestesia riducendo la concentrazione isoflurano al 1%. Chiudere la pelle con 5.0 punti di sutura non assorbibili (Figura 1L). </li></ol></li></ol> 3. Roux-en-Y bypass gastrico: Procedura chirurgica <ol><li> laparotomia mediana <ol><li> Sotto un microscopio binoculare e con un bisturi, effettuare un&#39;incisione mediana da sterno al centro dell&#39;addome per aprire la cavità addominale (non danneggiare i muscoli addominali). Proteggere la pelle con un impacco sterile imbevuta di 37 ° C soluzione salina (Figura 2B). </li></ol> &lt;/ Li&gt; <li> Arto biliopancreatica e degli arti alimentare <ol><li> Esteriorizzare l&#39;intestino (Figura 2C). Misura 8 cm dal piloro e eseguire due legature dell&#39;intestino con 5.0 punti di sutura non assorbibili (Figura 2D). </li><li> Tagliare l&#39;intestino tra le due legature (Figura 2E). Posizionare la parte prossimale delle due estremità nel quadrante superiore sinistro dell&#39;addome. Nota: verrà utilizzato quando l&#39;arto alimentare (Figura 2F). </li><li> Posizionare la parte distale delle due estremità affacciate dell&#39;arto alimentari 6 cm sotto il lembo prossimale (Figura 2F). NOTA: Questo verrà utilizzato come l&#39;arto biliare. </li></ol></li><li> Digiuno-digiunostomia <ol><li> Tagliare sia l&#39;arto prossimale e il ciclo intestinale con le forbici micro ed eseguire due incisioni antimesenterico della stessa lunghezza (figura 2G e 2H). </li><li> Eseguire lato a lato anastomosi con due 8.0suture non assorbibili. Eseguire la anastomosi lato dorsale prima (figura 2I), seguito dal anastomosi lato ventrale (Figura 2J). </li><li> Ruotare delicatamente 2 tamponi di cotone inumiditi verso ogni lato della anastomosi per garantire che la sutura è a tenuta stagna. Completare con 8,0 punti di sutura non assorbibili in caso di perdite. </li></ol></li><li> Gastro-jejunostomy <ol><li> mobilitare delicatamente lo stomaco utilizzando tamponi di cotone inumiditi. Liberare lo stomaco dai suoi stretti allegati del tessuto connettivo laterali utilizzando tamponi di cotone inumiditi o forbici micro. </li><li> Delicatamente, esternare lo stomaco pieno, mettendo un riassorbibile di collagene emostatico comprimere dietro lo stomaco. Eseguire una legatura del piloro utilizzando una sutura non riassorbibile 5.0 passata attraverso il omento con pinze micro curve (Figura 2K e 2L). </li><li> Tagliare sia la parte ventrale dello stomaco, 1,5 cm dal piloro, e l&#39;arto distaleusando forbici micro, creando due incisioni della stessa lunghezza (Figura 2M). </li><li> Eseguire anastomosi lato a lato con due 8.0 suture non assorbibili. Inizia con l&#39;anastomosi lato dorsale (Figura 2N), e quindi eseguire l&#39;anastomosi lato ventrale (Figura 2O). Ruotare delicatamente 2 tamponi imbevuto di cotone verso ogni lato della anastomosi per garantire che la sutura è a tenuta stagna. Completare con 8,0 punti di sutura non assorbibili in caso di perdite. </li></ol></li><li> chiusura addominale <ol><li> Chiudere lo strato muscolare della parete addominale con 5.0 punti di sutura non assorbibili (Figura 2P). Ridurre l&#39;anestesia riducendo la concentrazione isoflurano al 1%. Chiudere la pelle con 5.0 punti di sutura non assorbibili (Figura 2Q) .Administer 25 ml / kg di soluzione salina calda per via sottocutanea. </li></ol></li></ol> 4. Cura postoperatoria generale <ol><li> smettere di isofluranoe continuare con un flusso O 2 pari a 0,8 L / min fino a quando il mouse è completamente sveglio. Non lasciare il mouse senza sorveglianza fino a quando non riprende il controllo del motore, indicato dalla partenza degli animali di muoversi intorno alla gabbia e di essere in grado di stare in piedi e camminare senza cadere. </li><li> Posizionare il mouse (solo un topo per gabbia) in un incubatore di sotto dei 30 ° C condizione di temperatura per 5 giorni. </li><li> Mantenere ferro (0,5 mg / kg / giorno; iniezione sottocutanea) e vitamina (800 mg / 180 ml in acqua) integrazioni nei topi RYGB fino alla fine del protocollo. </li><li> Rientro libero accesso al gel di dieta alimentare (dieta gel alto contenuto di grassi: 10% strutto, il 10% di zucchero liquido, il 57% di acqua) per 5 giorni dopo l&#39;intervento chirurgico. Reintrodurre una dieta solida 3 giorni dopo l&#39;intervento. </li><li> Sottocutanea iniettare buprenorfina (0,1 mg / kg, due volte al giorno, dal giorno 0 al giorno 3 dopo l&#39;intervento chirurgico), meloxicam (1 mg / kg, dal giorno 0 al giorno 3 dopo l&#39;intervento chirurgico), metoclopramide (1 mg / kg, dal giorno 0 al giorno 5 dopo l&#39;intervento chirurgico), e marbofloxacine (10 mg / kg, dal giorno 0 al giorno 3 afte<html> R intervento chirurgico). </li></ol> La valutazione 5. postoperatoria metabolica Parametri <ol><li> Misura l&#39;assunzione di cibo <ol><li> Lasciare i topi di recuperare per 1 settimana dopo l&#39;intervento chirurgico. Casa del mouse uno per gabbia. Misurare la quantità di dieta solida collocato nella gabbia. Peso i restanti 24 ore più tardi alimentari. Ripetere questo passaggio il tempo necessario. </li></ol></li><li> Test di tolleranza al glucosio orale <ol><li> Digiunare i topi per 6 ore prima che il bolo orale. Raccogliere una goccia di sangue dalla punta della coda e applicarlo su una striscia di glucosio inserito in un glucometro per determinare il tempo di valore di glucosio nel sangue 0. </li><li> Somministrare un bolo orale della soluzione di D-glucosio 20% (2 g / kg). Misurare i livelli di glucosio nel sangue a 15, 30, 60 e 120 minuti dopo sonda gastrica. </li></ol></li><li> Analisi livello di emoglobina <ol><li> Utilizzando un sistema di ematologia, misurare 20 ml di sangue fresco per assaggiare il livello di emoglobina. </li></ol></li></ol>&quot;&gt; 6. Eutanasia <ol><li> Anestetizzare i topi per via intraperitoneale iniettando una soluzione xilazina / ketamina (10/80 mg / kg). Eseguire una dislocazione cervicale. Verifica completata l&#39;eutanasia facendo in modo che il cuore non batte e il riflesso corneale bulbo oculare è perduto. </li></ol>

<ol>
	<li>Ng, M., Fleming, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Global,+regional,+and+national+prevalence+of+overweight+and+obesity+in+children+and+adults+during+1980-2013:+a+systematic+analysis+for+the+Global+Burden+of+Disease+Study+2013.">Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.</a> The Lancet. 384 (9945), 766-781 (2014).</li><li>Calle, E. E., Thun, M. J., Petrelli, J. M., Rodriguez, C., Heath, C. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Body-mass+index+and+mortality+in+a+prospective+cohort+of+U.S.+adults.">Body-mass index and mortality in a prospective cohort of U.S. adults.</a> The New England Journal of Medicine. 341 (15), 1097-1105 (1999).</li><li>Sj&#246;str&#246;m, L., Lindroos, A. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lifestyle,+diabetes,+and+cardiovascular+risk+factors+10+years+after+bariatric+surgery.">Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery.</a> The New England Journal of Medicine. 351 (26), 2683-2693 (2004).</li><li>Buchwald, H., Avidor, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bariatric+surgery:+a+systematic+review+and+meta-analysis.">Bariatric surgery: a systematic review and meta-analysis.</a> JAMA. 292 (14), 1724-1737 (2004).</li><li>Yin, D. P., Gao, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+different+bariatric+surgeries+in+the+treatment+of+obesity+and+insulin+resistance+in+mice.">Assessment of different bariatric surgeries in the treatment of obesity and insulin resistance in mice.</a> Annals of surgery. 254 (1), 73-82 (2011).</li><li>Buchwald, H., Oien, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Metabolic/Bariatric+Surgery+Worldwide+2008.">Metabolic/Bariatric Surgery Worldwide 2008.</a> Obesity Surgery. 19 (12), 1605-1611 (2009).</li><li>Liu, W., Zassoko, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Establishment+of+duodenojejunal+bypass+surgery+in+mice:+A+model+designed+for+diabetic+research.">Establishment of duodenojejunal bypass surgery in mice: A model designed for diabetic research.</a> Microsurgery. 28 (3), 197-202 (2008).</li><li>Lan, Z., Zassoko, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+techniques+for+gastrojejunal+bypass+surgery+in+obese+mice.">Development of techniques for gastrojejunal bypass surgery in obese mice.</a> Microsurgery. , (2010).</li><li>Schlager, A., Khalaileh, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+mouse+model+for+sleeve+gastrectomy:+Applications+for+diabetes+research.">A mouse model for sleeve gastrectomy: Applications for diabetes research.</a> Microsurgery. 31 (1), 66-71 (2011).</li><li>Troy, S., Soty, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intestinal+Gluconeogenesis+Is+a+Key+Factor+for+Early+Metabolic+Changes+after+Gastric+Bypass+but+Not+after+Gastric+Lap-Band+in+Mice.">Intestinal Gluconeogenesis Is a Key Factor for Early Metabolic Changes after Gastric Bypass but Not after Gastric Lap-Band in Mice.</a> Cell Metabolism. 8 (3), 201-211 (2008).</li><li>Seyfried, F., Lannoo, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Roux-en-Y+gastric+bypass+in+mice--surgical+technique+and+characterisation.">Roux-en-Y gastric bypass in mice--surgical technique and characterisation.</a> Obesity surgery. 22 (7), 1117-1125 (2012).</li></ol>

The authors declare no conflicts of interest.

Per superare la crescente epidemia di obesità, le prime procedure di chirurgia bariatrica emersi nel 1960 negli Stati Uniti. Da allora, il numero di procedure eseguite in tutto il mondo ogni anno ancora aumentare, e oggi, queste tecniche rappresentano la migliore opzione terapeutica per la gestione di obesità patologica 6. Tra le procedure sviluppate, SG e RYGB sono i due metodi più utilizzati nella pratica clinica 4. I modelli animali, in particolare roditori, sono sta...

La pandemia mondiale di obesità e diabete è devastante gravità. Oltre due miliardi di adulti in tutto il mondo (il 30% della popolazione) sono in sovrappeso (BMI&gt; 25 kg / m 2) o obesi (BMI&gt; 30 kg / m 2) 1. Questo può venire con complicanze metaboliche, come il diabete di tipo 2, ipertensione, dislipidemia e, portando ad un aumento della morbilità e mortalità. L&#39;obesità aumenta la mortalità globale e la prevalenza di cancro 2. A causa della mancanza di eventuali trattamenti non invasivi efficaci, chirurgia bariatrica rappresenta l&#39;unica opzione che può portare a lungo termine, la perdita di peso sostenuto 3, 4. Un certo numero di differenti metodi chirurgici sono stati sviluppati, ma la gastrectomia manicotto (SG) e Roux-en-Y bypass gastrico (RYGB) sono le due procedure più comunemente utilizzati nella pratica clinica. Durante la procedura SG, 80% del volume iniziale dello stomaco èrimosso; pertanto, questa tecnica è uno degli interventi restrittivi che migliora sazietà. Il RYGB è una delle tecniche restrittive-malassorbimento. Durante RYGB, si crea una piccola tasca gastrica (1-2% del volume gastrico totale) e l&#39;intestino viene risistemato in una forma di Y, che ritarda la digestione e l&#39;assorbimento dei nutrienti. Queste due tecniche portano a riduzioni significative del peso corporeo e miglioramenti generali in comorbidità frequentemente associati (ad esempio, l&#39;ipertensione, il diabete di tipo 2, e dislipidemia) 3, con una maggiore efficienza visto in RYGB. Tuttavia, i meccanismi molecolari alla base degli effetti benefici pleiotropici degli chirurgia bariatrica sono spesso non completamente chiariti. A causa dei numerosi ceppi geneticamente modificati disponibili, un modello di topo è il più conveniente modello animale per esplorare questi meccanismi molecolari. Tuttavia, le procedure bariatrica sono difficili da adattare direttamente a modelli animali di piccole dimensioni e requiruna e alta manualità chirurgica. Mentre SG può essere facilmente eseguito in roditori con un tasso di sopravvivenza molto buono, RYGB è letale nei topi a causa di ostruzioni intestinali gravi 5. Diverse tecniche RYGB modificate sono state proposte per contrastare questo problema, in particolare il oesojejunostomy 5. Qui, vi presentiamo un&#39;altra alternativa: la gastrodigiunostomia senza asportazione dello stomaco. Questo RYGB modificato riproduce la maggior parte degli effetti benefici osservati negli esseri umani (per esempio, una significativa riduzione del peso corporeo e un miglioramento in glucosio e lipidi omeostasi). Questo manoscritto si propone di riassumere e discutere i dettagli tecnici e sperimentali di SG e RYGB nei topi e per facilitare queste procedure, con l&#39;aiuto di video. sarà resa Una caratteristica specifica riguardante l&#39;ottimizzazione dei protocolli sanitari preoperatorie e postoperatorie che consentono la riduzione delle vitamine e ferro carenze.

<table><tbody><tr><td>&lt;strong&gt;Drugs&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>High Fat diet</td><td>DIO diet</td><td>Safe</td><td></td></tr><tr><td>Isoflurane</td><td>Forane</td><td>Baxter</td><td></td></tr><tr><td>Buprenorphin</td><td>Buprecare</td><td>Animalcare</td><td></td></tr><tr><td>Marbofloxacine</td><td>Marbocyl</td><td>Vetoquinol</td><td></td></tr><tr><td>Ammonium iron citrate, vitamins PP-B12</td><td>Fercobsang</td><td>Vetoquinol</td><td></td></tr><tr><td>Vitamins A-D3-E-K-B</td><td>Vita Rongeur</td><td>Virbac</td><td></td></tr><tr><td>NaCl 0.9%</td><td>NaCl 0,9%</td><td></td><td></td></tr><tr><td>Povidone solution</td><td>Betadine Scrub</td><td>Betadine</td><td></td></tr><tr><td>Povidone solution</td><td>Betadine Solution</td><td>Betadine</td><td></td></tr><tr><td>Carboptol 980 NF</td><td>Ocrygel</td><td>TVM</td><td></td></tr><tr><td>&lt;strong&gt;Name&lt;/strong&gt;</td><td>&lt;strong&gt;References&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Comments&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;Sutures&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Prolene&amp;reg;</td><td>8.0, 6,5 mm</td><td>Ethicon</td><td></td></tr><tr><td>Prolene&amp;reg;</td><td>5.0, 13 mm</td><td>Ethicon</td><td></td></tr><tr><td>&lt;strong&gt;Name&lt;/strong&gt;</td><td>&lt;strong&gt;References&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Comments&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;Surgical equipments&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Scissors</td><td></td><td>FST</td><td></td></tr><tr><td>Needle holder</td><td>Olsen-Hegar</td><td>FST</td><td></td></tr><tr><td>Micro scissors</td><td>Vannas</td><td>FST</td><td></td></tr><tr><td>Micro forceps&amp;nbsp;</td><td>Graefe</td><td>FST</td><td></td></tr><tr><td>Micro forceps curved</td><td>Graefe</td><td>FST</td><td></td></tr><tr><td>Curved micro needle holder</td><td>Castroviejo</td><td>FST</td><td></td></tr><tr><td>Hemostatic collagen compress</td><td>Pangen</td><td>Urgo</td><td></td></tr><tr><td>Absorbent underpads</td><td></td><td>VWR</td><td></td></tr><tr><td>&lt;strong&gt;Name&lt;/strong&gt;</td><td>&lt;strong&gt;References&lt;/strong&gt;</td><td>&lt;strong&gt;Company&lt;/strong&gt;</td><td>&lt;strong&gt;Comments&lt;/strong&gt;</td></tr><tr><td>&lt;strong&gt;Specific equipments&lt;/strong&gt;</td><td></td><td></td><td></td></tr><tr><td>Hematology system&amp;nbsp;</td><td>Hemavet 950FS</td><td>Hemavet</td><td></td></tr><tr><td>Glucose strips and glucometer</td><td>One touch Verio</td><td>Life scan</td><td></td></tr><tr><td>Stereo microscope</td><td>MZ6</td><td>Leica&amp;nbsp;</td><td></td></tr></tbody></table>

techniques of sleeve gastrectomy and modified roux-en-y gastric bypass in mice

L&#39;obesità è un grave problema di salute pubblica, con una prevalenza di 4-28% per gli uomini e 6,2-36,5% per le donne in Europa (2003-2008). Obesità patologica è spesso associato a complicanze metaboliche, come il diabete di tipo 2, ipertensione, dislipidemia e, riducendo l&#39;aspettativa di vita e qualità. In assenza di eventuali trattamenti non invasivi efficaci, la chirurgia bariatrica è una valida opzione terapeutica per i pazienti con obesità patologica (indice di massa corporea (BMI)&gt; 40 kg / m 2), portando a lungo termine, sostenuta perdita di peso e miglioramenti complicanze metaboliche . Tuttavia, i meccanismi cellulari e molecolari alla base che sostengono gli effetti benefici della chirurgia bariatrica non sono ancora pienamente compreso. A causa delle numerose ceppi geneticamente modificati disponibili, il modello di topo è il più conveniente modello animale per esplorare i meccanismi molecolari alla base degli effetti benefici pleiotropici di chirurgia bariatrica. Qui, abbiamo dettagliato il healthc ottimizzatosono metodi e protocolli chirurgici nei topi per i due chirurgia bariatrica più utilizzati: la sleeve gastrectomy e modificato bypass gastrico Roux-en-Y. Decifrare i meccanismi molecolari alla base degli effetti terapeutici della chirurgia bariatrica offre la promessa di identificare nuovi bersagli terapeutici.

Condizioni generali Il tempo operatorio medio del procedimento SG era 49,3 ± 1,5 min. Abbiamo rimosso 62.8 ± 5.0 mg di stomaco, che rappresenta circa l&#39;80% per cento dello stomaco. Nessun topo morto durante l&#39;intervento chirurgico o durante i successivi sette giorni. Un mouse (7,1%) è morto il 11 ° giorno post-operatorio a causa di un&#39;ostruzione gastrica causata da un bezoar. <p ...

Watch this Scientific Journal Video about Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice at JoVE.com

Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice

Bariatric surgery is the most efficient way to reduce body weight and the deadly metabolic complications (diabetes, obesity, and dyslipidemia) frequently associated with morbid obesity. Mouse models of bariatric surgery represent a unique asset for deciphering molecular mechanisms behind the beneficial effects of these surgeries on diabetes, hypertension, and dyslipidemia.

Tecniche di sleeve gastrectomy e modificata Roux-en-Y bypass gastrico nei topi

Obesity is a major public health issue, with a prevalence of 4 to 28% for men and 6.2 to 36.5% for women in Europe (from 2003 to 2008). Morbid obesity is ...

techniques-sleeve-gastrectomy-modified-roux-en-y-gastric-bypass

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

11.9K Views.  INSERM, CNRS, UNIV Nantes. Bariatric surgery is the most efficient way to reduce body weight and the deadly metabolic complications (diabetes, obesity, and dyslipidemia) frequently associated with morbid obesity. Mouse models of bariatric surgery represent a unique asset for deciphering molecular mechanisms behind the beneficial effects of these surgeries on diabetes, hypertension, and dyslipidemia.

Video: Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice

Modified Technique for Coronary Artery Ligation in Mice

Myocardial infarction (MI) is one of the most important causes of mortality in humans1-3. In order to improve morbidity and mortality in patients with MI we need better knowledge about pathophysiology of myocardial ischemia. This knowledge may be valuable to define new therapeutic targets for innovative cardiovascular therapies4. Experimental MI model in mice is an increasingly popular small-animal model in preclinical research in which MI is induced by means of permanent or temporary ligation of left coronary artery (LCA)5. In this video, we describe the step-by-step method of how to induce experimental MI in mice.
The animal is first anesthetized with 2% isoflurane. The unconscious mouse is then intubated and connected to a ventilator for artificial ventilation. The left chest is shaved and 1.5 cm incision along mid-axillary line is made in the skin. The left pectoralis major muscle is bluntly dissociated until the ribs are exposed. The muscle layers are pulled aside and fixed with an eyelid-retractor. After these preparations, left thoracotomy is performed between the third and fourth ribs in order to visualize the anterior surface of the heart and left lung. The proximal segment of LCA artery is then ligated with a 7-0 ethilon suture which typically induces an infarct size ~40% of left ventricle. At the end, the chest is closed and the animals receive postoperative analgesia (Temgesic, 0.3 mg/50 ml, ip). The animals are kept in a warm cage until spontaneous recovery.

The surgical procedure used to induce experimental myocardial infarction in mice begins with left thoracotomy between the third and the fourth ribs in order to visualize the anterior surface of the heart and left lung. The left coronary artery is ligated, the chest is closed and the mouse is allowed to recover spontaneously.

Tecnica modificata di legatura dell&#39;arteria coronarica in Mouse

Myocardial infarction (MI) is one of the most important causes of mortality in humans1-3. In order to improve morbidity and mortality in patients with MI ...

Ricerca

Medicina

Roux-en-Y Gastric Bypass Operation in Rats

Currently, the most effective therapy for the treatment of morbid obesity to induce significant and maintained body weight loss with a proven mortality benefit is bariatric surgery1,2. Consequently, there has been a steady rise in the number of bariatric operations done worldwide in recent years with the Roux-en-Y gastric bypass (gastric bypass) being the most commonly performed operation3. Against this background, it is important to understand the physiological mechanisms by which gastric bypass induces and maintains body weight loss. These mechanisms are yet not fully understood, but may include reduced hunger and increased satiation4,5, increased energy expenditure6,7, altered preference for food high in fat and sugar8,9, altered salt and water handling of the kidney10 as well as alterations in gut microbiota11. Such changes seen after gastric bypass may at least partly stem from how the surgery alters the hormonal milieu because gastric bypass increases the postprandial release of peptide-YY (PYY) and glucagon-like-peptide-1 (GLP-1), hormones that are released by the gut in the presence of nutrients and that reduce eating12.
During the last two decades numerous studies using rats have been carried out to further investigate physiological changes after gastric bypass. The gastric bypass rat model has proven to be a valuable experimental tool not least as it closely mimics the time profile and magnitude of human weight loss, but also allows researchers to control and manipulate critical anatomic and physiologic factors including the use of appropriate controls. Consequently, there is a wide array of rat gastric bypass models available in the literature reviewed elsewhere in more detail 13-15. The description of the exact surgical technique of these models varies widely and differs e.g. in terms of pouch size, limb lengths, and the preservation of the vagal nerve. If reported, mortality rates seem to range from 0 to 35%15. Furthermore, surgery has been carried out almost exclusively in male rats of different strains and ages. Pre- and postoperative diets also varied significantly.
Technical and experimental variations in published gastric bypass rat models complicate the comparison and identification of potential physiological mechanisms involved in gastric bypass. There is no clear evidence that any of these models is superior, but there is an emerging need for standardization of the procedure to achieve consistent and comparable data. This article therefore aims to summarize and discuss technical and experimental details of our previously validated and published gastric bypass rat model.

Numerous studies using gastric bypass rat models have been recently conducted to uncover the underlying physiological mechanisms of Roux-en-Y gastric bypass operations. This article aims to demonstrate and discuss the technical and experimental details of our published gastric bypass rat model to understand advantages and limitations of this experimental tool.

Roux-en-Y operazione di bypass gastrico in Rats

Currently, the most effective therapy for the treatment of morbid obesity to induce significant and maintained body weight loss with a proven mortality ...

Assessment of Gastric Emptying in Non-obese Diabetic Mice Using a [13C]-octanoic Acid Breath Test

Gastric emptying studies in mice have been limited by the inability to follow gastric emptying changes in the same animal since the most commonly used techniques require killing of the animals and postmortem recovery of the meal1,2. This approach prevents longitudinal studies to determine changes in gastric emptying with age and progression of disease. The commonly used [13C]-octanoic acid breath test for humans3 has been modified for use in mice4-6 and rats7 and we previously showed that this test is reliable and responsive to changes in gastric emptying in response to drugs and during diabetic disease progression8. In this video presentation the principle and practical implementation of this modified test is explained. As in the previous study, NOD LtJ mice are used, a model of type 1 diabetes9. A proportion of these mice develop the symptoms of gastroparesis, a complication of diabetes characterized by delayed gastric emptying without mechanical obstruction of the stomach10.
This paper demonstrates how to train the mice for testing, how to prepare the test meal and obtain 4 hr gastric emptying data and how to analyze the obtained data. The carbon isotope analyzer used in the present study is suitable for the automatic sampling of the air samples from up to 12 mice at the same time. This technique allows the longitudinal follow-up of gastric emptying from larger groups of mice with diabetes or other long-standing diseases.

Assessment of Gastric Emptying in Non-obese Diabetic Mice Using a [13C]-octanoic Acid Breath Test

Determination of gastric emptying with a non-invasive [13C]-octanoic acid breath test for tracking gastroparesis in female NOD LtJ mice.

La valutazione di svuotamento gastrico in non-obesi topi diabetici utilizzando un [<sup&gt; 13</sup&gt; C]-ottanoico Breath Test Acid

Gastric emptying studies in mice have been limited by the inability to follow gastric emptying changes in the same animal since the most commonly used ...

Using the Sleeve Technique in a Mouse Model of Aortic Transplantation - An Instructional Video

Orthotopic aortic transplantation using the sleeve technique reduces injury to the aorta with failure rate of only 10-20%. The time to anastomose the aorta in mice using the sleeve method was short and easy averaging 20 min, permitting studies of iso/allo grafts. The following article describes the aortic transplantation procedure used in our laboratory. The mice were anesthetized with a mixture of 1.5% volume isoflurane and 100% oxygen through a face mask. At this point, the segment of the aorta between the renal arteries and its bifurcation was separated from the vena cava, freely prepared and clampedat the proximal and distal segments with a single silk suture. Prior to the removal of the aorta, a saline solution containing heparin was injected into the inferior vena cava. Then the aorta was cut between the clamps and a saline heparin solution was used to flush the lumen. The sleeve technique with monofilament sutures was used in order to transplant the abdominal aorta in the orthotopic position.

We present an orthotopic aortic transplantation model using the sleeve technique in mice. It is a very rapid anastomosis method, which can be employed in studies of vascular disease.

Utilizzando la tecnica di manica in un modello murino di trapianto aortico - un Video didattico

Orthotopic aortic transplantation using the sleeve technique reduces injury to the aorta with failure rate of only 10-20%. The time to anastomose the ...

Sleeve Gastrectomy in Mice using Surgical Clips

The number of people who are overweight and obese is continually increasing both in the adult and adolescent populations. This coincides with the increased universal phenomenon of type 2 diabetes (T2D) and other metabolic problems. Bariatric surgery, such as SG, is currently one of the most effective and commonly used long-term treatment for obesity and T2D, but the association between them is not completely explored yet. The mechanisms underlying the outcomes seen after bariatric surgery in humans can be investigated based on preclinical animal studies. The SG reduces body weight, glucose levels and many metabolic parameters, and is easy to perform with a low incidence of complications. The goal of this work is to provide a simple method and an uncomplicated preclinical model of bariatric surgery in animals for researchers.

The prevalence of diabetes and obesity is continuously increasing worldwide. The mechanisms between diabetes, obesity and their associated mortality and co-morbidities need to be further investigated. Here, we present a protocol for sleeve gastrectomy (SG) in animals as an uncomplicated preclinical model of bariatric surgery.

Gastrectomia a maniche nei topi con clip chirurgiche

The number of people who are overweight and obese is continually increasing both in the adult and adolescent populations. This coincides with the ...

A Protocol for Roux-en-Y Gastric Bypass in Rats using Linear Staplers

Roux-en-Y gastric bypass (RYGB) is commonly performed for the treatment of severe obesity and type 2 diabetes. However, the mechanism of weight loss and metabolic changes are not well understood. Multiple factors are thought to play a role, including reduced caloric intake, decreased nutrient absorption, increased satiety, the release of satiety-promoting hormones, shifts in bile acid metabolism, and alterations in the gut microbiota.
The rat RYGB model presents an ideal framework to study these mechanisms. Prior work on mouse models have had high mortality rates, ranging from 17 to 52%, limiting their adoption. Rat models demonstrate more physiologic reserve to surgical stimulus and are technically easier to adopt as they allow for the use of surgical staplers. One challenge with surgical staplers, however, is that they often leave a large gastric pouch which is not representative of RYGB in humans. 
In this protocol, we present a RYGB protocol in rats that result in a small gastric pouch using surgical staplers. Utilizing two stapler fires which remove the forestomach of the rat, we obtain a smaller gastric pouch similar to that following a typical human RYGB. Surgical stapling also results in better hemostasis than sharp division. Additionally, the forestomach of the rat does not contain any glands and its removal should not alter the physiology of RYGB.
Weight loss and metabolic changes in the RYGB cohort were significant compared to the sham cohort, with significantly lower glucose tolerance at 14 weeks. Furthermore, this protocol has an excellent survival of 88.9% after RYGB. The skills described in this protocol can be acquired without previous microsurgical experience. Once mastered, this procedure will provide a reproducible tool for studying the mechanisms and effects of RYGB.

Roux-en-Y gastric bypass (RYGB) is performed to treat obesity and diabetes. However, the mechanisms underlying RYGB's efficacy are not fully understood, and studies are limited by technical difficulty leading to high mortality in animal models. This article provides instructions on how to perform RYGB in rats with high success rates.

Un protocollo per il bypass gastrico Roux-en-Y nei ratti che utilizza cucitrici lineari

Roux-en-Y gastric bypass (RYGB) is commonly performed for the treatment of severe obesity and type 2 diabetes. However, the mechanism of weight loss and ...

Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Model in Mice

Obesity is a major health issue worldwide. As a response, bariatric surgeries have emerged to treat obesity and its related comorbidities (e.g., diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, cardiovascular events, and cancers) through restrictive and malabsorptive mechanisms. Understanding the mechanisms by which these procedures allow such improvements often require their transposition into animals, especially in mice, because of the ease of generating genetically modified animals. Recently, the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has emerged as a procedure that uses both restrictive and malabsorptive effects, which is being used as an alternative to gastric bypass in case of major obesity. Thus far, this procedure has been associated with strong metabolic improvements, which has led to a marked increase in its use in daily clinical practice. However, the mechanisms underlying these metabolic effects have been poorly studied as a result of a lack of animal models. In this article, we present a reliable and reproducible model of SADI-S in mice, with a special focus on perioperative management. The description and use of this new rodent model will be helpful for the scientific community to better understand the molecular, metabolic, and structural changes induced by the SADI-S and to better define the surgical indications for clinical practice.

Single-anastomosis duodeno-ileal bypass (SADI-S) is an emerging bariatric procedure with important metabolic effects. In this article, we present a reliable and reproducible model of SADI-S in mice.

Bypass duodeno-ileale a singola anastomosi con modello di gastrectomia a manica nei topi

Obesity is a major health issue worldwide. As a response, bariatric surgeries have emerged to treat obesity and its related comorbidities (e.g., diabetes ...

A Murine Model of Vertical Sleeve Gastrectomy

Bariatric surgery, such as vertical sleeve gastrectomy (VSG), is a surgery of the gastrointestinal tract that is performed for the purpose of weight loss. Bariatric surgery is currently the most effective long-term treatment for obesity. In addition to weight loss, bariatric surgery produces additional health benefits such as remission of type 2 diabetes, remission of hypertension, and decreased risk of developing certain types of cancer. The mechanisms beyond weight loss for these benefits remain incompletely defined. Therefore, animal models of bariatric surgery are being developed and validated to identify the mechanisms leading to these benefits, with the goal of improving understanding of gastrointestinal physiology and identifying new therapeutic targets. VSG has become the most commonly performed bariatric procedure in the clinic in the United States because it is highly effective at producing weight loss and metabolic improvement, and is simpler to perform than other bariatric procedures. Therefore, we have developed and validated a murine model of VSG. This murine VSG model recapitulates many of the effects of VSG seen in humans, including improved glucose and blood pressure regulation. The method is based on isolation of the stomach, ligation of gastric vessels, and removal of 70% of the stomach by transecting along the greater curvature of the stomach. We have successfully applied this surgical protocol to various genetically modified mouse lines to define the mechanistic contributors to the benefits of VSG. Furthermore, this murine VSG model has been combined with other surgical techniques, to achieve deeper mechanistic insight. Therefore, this is a simple and versatile model for studying gastrointestinal physiology and the health benefits of bariatric surgery.

The following describes the performance of vertical sleeve gastrectomy in mice. This is a type of weight-loss surgery that involves removal of approximately 70% of the stomach.

Un modello murino di gastrectomia verticale

Bariatric surgery, such as vertical sleeve gastrectomy (VSG), is a surgery of the gastrointestinal tract that is performed for the purpose of weight loss. ...

Biologia

Roux-en-Y Gastric Bypass Procedure: A Bariatric Surgical Procedure for Gastric Resectioning in Murine Model

Source: Ayer, A., et al., <a href="https://jove.unicartagenaproxy.elogim.com/v/54905">Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice.</a> J. Vis. Exp. (2017).
This video describes a bariatric surgery-Roux-en-Y procedure. This involves the cutting of the jejunum- the middle portion of the intestine- to generate two intestinal limbs. The biliary limb is attached to the existing intestinal loop and the alimentary limb is attached to the stomach, creating a gastric bypass. The gastric bypass created here helps to decrease the nutrient uptake and efficiently reduces body weight.

Procedura di bypass gastrico Roux-en-Y: una procedura chirurgica bariatrica per la resezione gastrica in modello murino

Source: Ayer, A., et al., Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice. J. Vis. Exp. (2017).
This video describes a ...

JoVE Encyclopedia of Experiments

Rodent Models

Adult

Murine Vertical Sleeve Gastrectomy: A Surgical Procedure to Downsize Stomach in Experimental Mouse Models

Before beginning the procedure, apply veterinary ointment to the eyes of an anesthetized mouse and place the mouse on a heating pad. Remove the hair from the umbilicus to the axilla, gently holding the skin taut to avoid skin lesions, and use cotton tip applicators to sequentially disinfect the exposed skin with povidone-iodine and ethanol.
Wearing sterile gloves and using sterile technique, place sterile surgical drapes on either side of the animal. Cut a small hole in the foil to allow access to the mouse&#39;s abdomen and use a piece of autoclaved aluminum foil as a surgical drape. Make a skin incision from the mid-abdomen to the xiphoid cartilage.
Under a dissecting microscope, use iris scissors to cut through the body wall along the linea alba and use new cotton tip applicators to gently elevate the stomach out of the abdomen. Bluntly dissect the greater omentum from the greater curvature of the stomach.
Then, use 7.0 monofilament absorbable sutures to place two ligatures around the short gastric artery that runs between the fundus of the stomach and the spleen. When both ligatures have been placed, use spring scissors to cut between the two sutures and fully exteriorize the stomach from the abdominal cavity.
Place gauze under the stomach and hydrate the organ with saline. For a vertical sleeve gastrectomy procedure, use a 7.0 monofilament absorbable suture with a taper needle to ligate the prominent branches of the gastric artery and vein, just below the intended line of transection. Place a simple continuous line of 6.0 monofilament absorbable suture through both gastric walls, just below the intended line of transection, to prevent spillage of the gastric contents.
Place thin-tipped hemostats above the suture line and use spring scissors to cut between the suture line and the hemostats. Remove the transected gastric tissue from the sterile surgical field and use fresh cotton tip applicators to clean the blood and digesta from the stomach.
Use a 6.0 monofilament absorbable suture with a taper needle to reinforce the apposition of the gastric walls in a simple discontinuous pattern. Using a 20G gavage needle attached to a 20-milliliter syringe, perform gastric lavage with fresh saline and securely close the stomach with a minimum of 20 knots.
Then, gently press the stomach with a cotton applicator to test for leaks. If no leaks are detected, lavage the stomach with at least 60 more milliliters of fresh saline to remove any infectious particulates.
After the procedure, use a cotton tip applicator to return the stomach under the liver within the abdominal cavity and place an applicator along the dorsal aspect of the abdominal cavity to absorb any excess fluid.
Use a blunt 18G needle to inject lactated Ringer&#39;s solution with or without antibiotics directly into the abdominal cavity, and use 6.0 monofilament absorbable sutures to close the abdominal muscle layer in a simple discontinuous pattern and the skin layer in a simple continuous pattern. Then, place tissue adhesive on the skin and fold the skin over the suture line to protect the suture from disruption by the animal.

Tecniche di sleeve gastrectomy e modificata Roux-en-Y bypass gastrico nei topi

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Tecnica modificata di legatura dell'arteria coronarica in Mouse