C密封的项目是一个手术大学医学中心的格罗宁根（UMCG）和Polyganics BV的部门之间的合作的一部分。该项目最初是SenterNovem荷兰经济事务部的赠款支持。 Polyganics BV的知识产权，商业利益和专利持有。智趣的UMCG举行。 Polyganics BV已经生产了这项研究的设备。这项研究是在UMCG执行。

制备的C -密封 C密封制成的可生物降解的聚氨酯软，硬的分​​子元件组成，。硬盘组件提供了理想的弹性和力学性能的材料。硬盘组成部分的一个DI -异氰酸酯（OCN - NCO）和丙二醇（HO - OH）。组成聚氨酯的绑定（异氰酸2） 软段决定了聚氨酯的降解行为。软段被称为预聚物和聚醚酯链组成。软段硬段被纳入。此法团被称为“链延伸”的聚合。 一旦这两个领域的互动，聚醚酯的聚氨酯合成聚合物是准备到C -密封处理： <ol><li>稀释到浓度适于喷涂的聚合物。 </li><li>在一个旋转的模具到一定厚度的聚氨酯溶液喷洒。 </li><li>为了安全不造成损害的情况下从模具释放C密封模具放入水浴。 </li><li> C密封干燥。 </li><li> C密封在泰维克袋包装，并用环氧乙烷气体消毒。 </li><li> C密封消毒后，准备使用。 </li></ol>外科手术病人参与的C -密封研究的知情同意。 <ol><li>病人是在仰卧位箍筋的位置，腹部及会阴部的消毒和病人用无菌窗帘覆盖。 </li><li>建立腹或经正中切口开腹手术。 </li><li>检查肝脏和腹腔。 </li><li>脾曲的乙状结肠和动员动员。 </li><li>在开放性手术：乙状结肠近端切缘的水平分工。 </li><li>右paramedian切口腹膜，骶前飞机开放;结扎和优越的直肠中动脉和静脉分工。 </li><li>调动直肠系膜。 </li><li>部的直肠远端。 </li><li>在腹腔镜设置：耻骨上切口进行提取样本。乙状结肠近端部。 </li><li>如果直肠残端的长度是最大，可用于C密封。 15厘米。 </li><li>肠管直径决定订书机直径;我们更愿意使用一个直径为29或33毫米的一个CEA的订书机。 </li><li> C密封和消毒12毫米不锈钢大理石解压缩在清洁和消毒，使用清洁和无菌手术手套的表面。 </li><li>打开C密封，插入大理石，首先插入连接针砧。在开放的C -密封的两个皮瓣砧用胶带条。 </li><li>砧是先进的C -密封，使连接针“刺破”打开C密封指出年底。轻轻地完全展开的C -密封，并确保大理石结束砧内的C -密封远离。 </li><li>吻合的任何类型（终端到终端，到另一侧，侧高端一侧到另一侧）时，可以使用的C -密封;我们希望创建一个侧端吻合。有多个战略中插入近端肠袢砧。 C密封不干预任何与这些战略（pursestring缝合/纵向肠道切口开放排便结束） </li><li>推进C密封的大理石的帮助，必要时，钝钳插入砧与C - DE近端肠袢密封。确保C密封的尾巴是向上，放置在肠道检查，C密封的尾巴是捉襟见肘;检查的大理石（大理石应在足够的距离砧）的位置。然后穿透肠壁与砧的PIN，并创建一个pursestring周围针缝合。 </li><li>轻轻扩张肛门插入直肠残端吻合器。连接订书机砧。检查肠道扭转。 </li><li>消防圆形订书机。现在，肠的两端均连接和C密封连接到斯台普斯</li><li>轻轻拉出肛门订书机。不要超过180度转动订书机拉出时（C密封可能扭曲）。从直肠通过消除装订器，C密封是通过肛门拉出。 C密封削减从肛门约4厘米的距离。 </li><li>从直肠中取出的大理石。通常的大理石与C -密封出来。如果不是这样，轻轻地手动删除，这是位于C密封和肠壁之间的大理石。 </li><li>验证吻合。或者，用生理盐水溶液充填骨盆执行空气测试，并注入肛管（C密封之间的C -密封和肠道内）的空气。 ABS的ENCE的气泡，证实了一个完整的吻合。 </li><li>如果表示，创建一个保护造口。 </li><li>在腹腔镜设置：exsufflation腹腔及套管提取。 </li><li>关闭切口（S） </li><li>术后阶段： 术后恢复是根据9时代（手术后提高采收率）协议。 C密封应留在原地至少一个星期。病人没有限制，并且可以通过C -密封失去大便。当病人恢复良好，无吻合口并发症的怀疑，C密封​​可能会削减在肛门水平。其余的C -密封会降低，病人将失去C密封大便通过自然途径。 </li></ol>代表性的成果当C -密封正确（图2和3）应用，它涵盖了吻合。如果裂开形成吻合口或从远端近端直肠残端吻合，防止粪便外渗，由于C -密封覆盖的缺陷和指示通过肛门的排泄物。在术后阶段，从肛门（图3）C密封突出。 <img src="/files/ftp_upload/2223/2223fig1.jpg" alt="图1" /> 图1：C密封示意图。 <img src="/files/ftp_upload/2223/2223fig2.jpg" alt="图2" /> 图2：附加C密封装订器头部示意图。 <img src="/files/ftp_upload/2223/2223fig3.jpg" alt="图3" /> 图3：订书机头插入与近端肠管和直肠残端吻合器附加C密封后，装订器发射和通过肛门轻轻拉与C -密封。

<ol>
	<li>Peeters, K. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+factors+for+anastomotic+failure+after+total+mesorectal+excision+of+rectal+cancer.">Risk factors for anastomotic failure after total mesorectal excision of rectal cancer.</a> Br. J. Surg. 92, 211-216 (2005).</li><li>Dehni, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+a+defunctioning+stoma+on+leakage+rates+after+low+colorectal+anastomosis+and+colonic+J+pouch-anal+anastomosis.">Influence of a defunctioning stoma on leakage rates after low colorectal anastomosis and colonic J pouch-anal anastomosis.</a> Br. J. Surg. 85, 1114-1117 (1998).</li><li>Matthiessen, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+factors+for+anastomotic+leakage+after+anterior+resection+of+the+rectum.">Risk factors for anastomotic leakage after anterior resection of the rectum.</a> Colorectal Dis. 8, 366-366 (2006).</li><li>Laxamana, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+results+of+anterior+resection+using+the+double-stapling+technique.">Long-term results of anterior resection using the double-stapling technique.</a> Dis. Colon Rectum. 38, 1246-1250 (1995).</li><li>Jung, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+factors+and+oncologic+impact+of+anastomotic+leakage+after+rectal+cancer+surgery.">Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery.</a> Dis. Colon Rectum. 51, 902-908 (2008).</li><li>Ravo, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+intracolonic+bypass+procedure.">The intracolonic bypass procedure.</a> Int. J. Colorectal Dis. 2, 38-42 (1987).</li><li>Ye, F., Wang, D., Xu, X., Liu, F., Lin, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+intracolonic+bypass+secured+by+a+biodegradable+anastomotic+ring+to+protect+the+low+rectal+anastomosis.">Use of intracolonic bypass secured by a biodegradable anastomotic ring to protect the low rectal anastomosis.</a> Dis. Colon Rectum. 51, 109-115 (2008).</li><li>Hawley, P. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Causes+and+prevention+of+colonic+anastomotic+breakdown.">Causes and prevention of colonic anastomotic breakdown.</a> Dis. Colon Rectum. 16, 272-277 (1973).</li><li>Lassen, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Consensus+review+of+optimal+perioperative+care+in+colorectal+surgery:+Enhanced+Recovery+After+Surgery+(ERAS)+Group+recommendations.">Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations.</a> Arch. Surg. 144, 961-969 (2009).</li><li>Kolkert, J. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Protection+of+stapled+colorectal+anastomoses+with+a+biodegradable+device:+the+C-seal+feasibility+study.">Protection of stapled colorectal anastomoses with a biodegradable device: the C-seal feasibility study.</a> Am J of Surg. , .</li></ol>

IRB批准：涉及人类受试者的程序已经由机构审查委员会（IRB）批准的格罗宁根大学医学中心和荷兰研究中央委员会INV。 （CCMO）人体实验对象。没有利益冲突的声明。

C密封是一种技术，旨在防止装订结直肠吻合的吻合口漏。它可以使用以及在腹腔镜手术期间剖腹探查术。 C密封不防止吻合口裂开，但是，它可以防止肠道管腔外的粪便泄漏。 当应用C密封，格外小心，应采取在C密封插入近端肠袢的那一刻起。近端肠袢C密封足够的定位是很重要的，因为它理论上是可能的双主食C密封的。 C密封双吻合器时，会发生C密封的尾部折叠和装订器和装订器头部之间。大理石有助于确定在近端肠袢的C -密封的位置。大理石应定位在足够的距离订书机头部，保证C密封的尾巴是捉襟见肘，不能成为装订与吻合在一起。 C密封可定位在以不同的方式近端肠袢。如果一个侧端吻合术是首选，我们建议执行此根据以下协议：插入C密封是通过开放式的排便结束，尾其次订书机头。连接端子，然后通过肠壁渗入刺向开放排便结束的方向。随后，开​​放排便年底关闭和连接端子周围放置一个pursestring缝合是提供额外的支撑。该引脚连接到订书机，大理石的位置被选中和装订器发射。 如果对端吻合是首选，C密封是在开放的近端肠管结束插入，尾巴第一。一个pursestring缝合环绕周围的连接引脚排便结束。该引脚连接到订书机，大理石的位置被选中和装订器发射。 C密封在格罗宁根大学医学中心启动了一个试点研究，受聘于15个接受由吻合器吻合 10直肠切除术的患者。在这些患者被诊断为无临床或亚临床AL。目前，第二阶段的研究，测试在另外35例患者的C -密封招聘。

<table border="1">
		<thead>
		<tr>
		<th>Material Name</th>
		<th>Type</th>
		<th>Company</th>
		<th>Catalogue Number</th>
		<th>Comment</th>
		</tr>
		</thead>
		<tbody>
		
<tr>
<td>Stainless Steel Marble</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td>C-seal</td>
<td>&nbsp;</td>
<td>Polyganics</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
		</tbody>
		</table>

the c-seal: a biofragmentable drain protecting the stapled colorectal anastomosis from leakage

结直肠吻合口瘘（阿盟）在大肠癌手术，导致高发病率和死亡率 1严重的并发症。 AL的发病率差异2.5和20之间的 2-5％ 。多年来，许多战略旨在降低吻合口瘘的的发生率已经检查6， 7。 AL的原因可能是多因素。病因包括动脉血液供应不足，吻合口的张力，血肿和/或在吻合口部位的感染，和病人共同病态的因素，如糖 ​​尿病和动脉粥样硬化8。此外，一些吻合，可能是由于技术故障，从一开始就不足。 目前，新设备在我们的研究所，旨在保护结直肠吻合术和AL的发病率降低。所谓C型密封，这是一个biofragmentable流失，这是与圆形订书机装订吻合。它涵盖了大肠癌从而防止渗漏的吻合的管腔侧。 C密封是一个漏薄壁筒状，一个直径约4厘米，一个约25厘米（图1）的长度。它是一种可生物降解的聚氨酯组成的管状设备。管的一端用胶带襟翼发现。这些皮瓣用于连接C密封的圆形订书机砧，使吻合后的C -密封可通过肛门拉。 C密封仍然在原地至少10天。此后，它会失去强度，会降低身体分泌与胃肠道的天然内容。 C密封并不妨碍dehiscences形成。然而，它可以防止粪便外渗，进入腹膜腔。这意味着，在吻合口部位的差距不会导致泄漏。 目前，第二阶段的研究，检测了35例经历（结肠）吻合器吻合直肠切除招聘C密封。 C密封可用于在公开的程序，以及腹腔镜手术。 C密封只适用于内15厘米从肛门边缘吻合器吻合。在视频中，C密封的应用是在一个开放的扩展乙状结肠切除术，从一个狭窄的结肠憩室病病人的痛苦。

Watch this Scientific Journal Video about The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage at JoVE.com

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage

C密封是biofragmentable保护装订结直肠吻合口漏。在这段视频中，制造，部署和使用的详细信息显示。

C密封：一个Biofragmentable漏漏电保护吻合结直肠吻合

Colorectal anastomotic leakage (AL) is a serious complication in colorectal surgery leading to high morbidity and mortality rates1. The incidence of AL ...

the-c-seal-biofragmentable-drain-protecting-stapled-colorectal

Research

JoVE Journal

Medicine

21.7K 次观看.  University Medical Center Groningen. C密封是biofragmentable保护装订结直肠吻合口漏。在这段视频中，制造，部署和使用的详细信息显示。

视频: The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage

Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System

The use of modern endoscopy for research purposes has greatly facilitated our understanding of gastrointestinal pathologies. In particular, experimental endoscopy has been highly useful for studies that require repeated assessments in a single laboratory animal, such as those evaluating mechanisms of chronic inflammatory bowel disease and the progression of colorectal cancer. However, the methods used across studies are highly variable. At least three endoscopic scoring systems have been published for murine colitis and published protocols for the assessment of colorectal tumors fail to address the presence of concomitant colonic inflammation. This study develops and validates a reproducible endoscopic scoring system that integrates evaluation of both inflammation and tumors simultaneously. This novel scoring system has three major components: 1) assessment of the extent and severity of colorectal inflammation (based on perianal findings, transparency of the wall, mucosal bleeding, and focal lesions), 2) quantitative recording of tumor lesions (grid map and bar graph), and 3) numerical sorting of clinical cases by their pathological and research relevance based on decimal units with assigned categories of observed lesions and endoscopic complications (decimal identifiers). The video and manuscript presented herein were prepared, following IACUC-approved protocols, to allow investigators to score their own experimental mice using a well-validated and highly reproducible endoscopic methodology, with the system option to differentiate distal from proximal endoscopic colitis (D-PECS).

Over the past few years, new generation endoscopes have emerged as important diagnostic research aids for evaluating murine colitis and colorectal tumors. We present herein a detailed protocol for endoscopic assessment of inflammation and colorectal tumors in mice, as well as a novel scoring system that uses decimal identifiers to document the endoscopic severity of colitis and colorectal tumors.

灵活的结肠镜检查在小鼠使用经过验证的内镜评分系统来评估结肠炎和结肠直肠肿瘤的严重程度

The use of modern endoscopy for research purposes has greatly facilitated our understanding of gastrointestinal pathologies. In particular, experimental ...

科研

医学

Molecular Profiling of the Invasive Tumor Microenvironment in a 3-Dimensional Model of Colorectal Cancer Cells and Ex vivo Fibroblasts

Invading colorectal cancer (CRC) cells have acquired the capacity to break free from their sister cells, infiltrate the stroma, and remodel the extracellular matrix (ECM). Characterizing the biology of this phenotypically distinct group of cells could substantially improve our understanding of early events during the metastatic cascade.

Tumor invasion is a dynamic process facilitated by bidirectional interactions between malignant epithelium and the cancer associated stroma. In order to examine cell-specific responses at the tumor stroma-interface we have combined organotypic co-culture and laser micro-dissection techniques.
Organotypic models, in which key stromal constituents such as fibroblasts are 3-dimentioanally co-cultured with cancer epithelial cells, are highly manipulatable experimental tools which enable invasion and cancer-stroma interactions to be studied in near-physiological conditions.

Laser microdissection (LMD) is a technique which entails the surgical dissection and extraction of the various strata within tumor tissue, with micron level precision.
By combining these techniques with genomic, transcriptomic and epigenetic profiling we aim to develop a deeper understanding of the molecular characteristics of invading tumor cells and surrounding stromal tissue, and in doing so potentially reveal novel biomarkers and opportunities for drug development in CRC.&#160;&#160;&#160;

Molecular Profiling of the Invasive Tumor Microenvironment in a 3-Dimensional Model of Colorectal Cancer Cells and Ex vivo Fibroblasts

Molecular profiling of laser microdissected cells and stroma from synthetic, tissue-engineered colorectal cancer models represents a novel and manipulatable approach to characterize and dissect the distinctive biology at the interface between tumor cells at the invasive front and cancer associated stromal cells. &#160;

在结直肠癌细胞的三维模型的入侵肿瘤微环境的分子剖析和<em&gt;体外</em&gt;成纤维细胞

Invading colorectal cancer (CRC) cells have acquired the capacity to break free from their sister cells, infiltrate the stroma, and remodel the ...

Isolation and Propagation of Circulating Tumor Cells from a Mouse Cancer Model

Cancer metastasis is the foremost cause of cancer-associated deaths. Recent studies have shown that circulating tumor cells (CTCs) are important in cancer metastasis. Indeed, the number of CTCs correlates with tumor size. Here, a detailed description is provided of a methodology for isolation and propagation of CTCs from a syngeneic mouse model of hepatocellular carcinoma (HCC) which allows for downstream analysis of potentially important molecular mechanisms of solid organ tumor metastasis. This method is efficient and reproducible. It is a non-invasive technique and, therefore, has potential to replace the invasive biopsy of tissues from humans which may be associated with complications. Therefore, the method discussed here allows for the isolation and propagation of CTCs from whole blood samples such that they can be examined and characterized. This has potential for future adaptation for clinical applications such as diagnosis, and personalized targeted therapy.

Circulating tumor cells (CTCs) have been shown to play an important role in tumor metastasis. Here, a method for the isolation and propagation of CTCs from the whole blood of a syngeneic mouse tumor model of hepatocellular carcinoma (HCC) metastasis is described.

从小鼠癌症模型的循环肿瘤细胞的分离和繁殖

Cancer metastasis is the foremost cause of cancer-associated deaths. Recent studies have shown that circulating tumor cells (CTCs) are important in cancer ...

Vessel-sparing Excision and Primary Anastomosis

Urethroplasty is considered to be the standard treatment for urethral strictures since it provides excellent long-term success rates. For isolated short bulbar or posterior urethral strictures, urethroplasty by excision and primary anastomosis (EPA) is recommended. As EPA only requires the excision of the narrowed segment and the surrounding spongiofibrosis, a full-thickness transection of the corpus spongiosum, as performed in the traditional transecting EPA (tEPA), is usually unnecessary. Jordan et al. introduced the idea of a vessel-sparing approach in 2007, aiming to reduce surgical trauma, especially to the dual arterial blood supply of the urethra, and, thus, potentially reducing the risk of postoperative erectile dysfunction or glans ischemia. This approach could also be beneficial for subsequent urethral interventions such as redo urethroplasty using a free graft, in which a well-vascularized graft bed is imperative. Nevertheless, these potential benefits are only assumptions as prospective studies comparing the functional outcome of both techniques with validated questionnaires are currently lacking. Moreover, vessel-sparing EPA (vsEPA) should at least be able to provide similar surgical outcomes as tEPA. The aim of this paper is to give an elaborate, step-by-step overview of how to manage patients with isolated short bulbar or posterior urethral strictures with vsEPA. The main objective of this manuscript is to outline the surgical technique and to report the representative surgical outcome. A total of 117 patients were managed according to the described protocol. The analysis was performed on the entire patient cohort and on the bulbar (n = 91) and posterior (n = 26) vsEPA group separately. Success rates were 93.4% and 88.5% for the bulbar and posterior vsEPA, respectively. To conclude, vsEPA, as outlined in the protocol, provides excellent success rates with low complication rates for isolated short bulbar and posterior urethral strictures.

Here, we present an elaborate and efficient protocol to treat isolated short bulbar or posterior urethral strictures with vessel-sparing excision and primary anastomosis.

血管保留切除术与原发性吻合术

Urethroplasty is considered to be the standard treatment for urethral strictures since it provides excellent long-term success rates. For isolated short ...

Creation of Colonic Anastomosis in Mice

Intestinal anastomoses are commonly performed in both elective and emergent operations. Even so, anastomotic leaks are a highly feared complications of colonic surgeries and can occur in up to 26% of surgical anastomoses, with mortality being up to 39% for patients with such a leak. Currently, there remains a paucity of data detailing the cellular mechanisms of anastomotic healing. Devising preventative strategies and treatment modalities for anastomotic leak could be greatly potentiated by a better understanding of appropriate anastomotic healing.
A murine model is ideal as previous studies have shown that the murine anastomosis is the most clinically similar to the human case as compared with other animal models. We offer an easily reproducible murine model of colonic anastomosis in mice that will allow for further illustration of anastomotic healing.

Anastomotic leak or breakdown after surgery is a major cause of postoperative morbidity and mortality. Our surgery for creating a colonic anastomosis is a reliable and reproducible method for studying the healing mechanisms of anastomoses.

小鼠结肠吻合术的建立

Intestinal anastomoses are commonly performed in both elective and emergent operations. Even so, anastomotic leaks are a highly feared complications of ...

One-anastomosis Gastric Bypass (OAGB) in Rats

The goal of this protocol is to set up a preclinical model of bariatric surgery and, more specifically, OAGB in obese rats. Based on this preclinical model, longitudinal studies can be carried out to provide an improved understanding of the mechanisms underlying the outcomes seen after bariatric surgery in humans. For this purpose, rats are operated on through a laparotomy under general anesthesia with isoflurane. First, the surgeon creates a long and tubular gastric pouch: after greater curve and hiatal dissection, the nonglandular stomach is stapled and removed. Then, the remaining stomach is also stapled in order to create a gastric tube and exclude the antrum of the stomach. After that, the surgeon performs a single end-to-side gastrojejunostomy 35 cm from the duodenojejunal angle. This limb length has been chosen in order to reproduce the same ratio between the biliopancreatic limb (BPL) and common limb (CL) length as in human bariatric surgery. The operation ends by aponeurotic and cutaneous closure. The early postoperative management consists of subcutaneous hydration, an intramuscular prophylactic antibiotic injection, a parietal injection of xylocaine, the administration of painkillers, and a progressive reintroduction of diet.

One-anastomosis Gastric Bypass OAGB in Rats

This protocol is for the performance of one-anastomosis gastric bypass (OAGB) on rat. The operator performs a long and tubular-stapled gastric pouch followed by hand-sewn anastomosis. For this model, the operator reproduces the same ratio between biliopancreatic and common limb in humans; therefore, the biliopancreatic limb measures 35 cm.

大鼠胃旁路 (oagb) 的一次吻合

The goal of this protocol is to set up a preclinical model of bariatric surgery and, more specifically, OAGB in obese rats. Based on this preclinical ...

Murine Appendectomy Model of Chronic Colitis Associated Colorectal Cancer by Precise Localization of Caecal Patch

The human appendix has been recently implicated to play important biological roles in the pathogenesis of various complex diseases, such as colorectal cancer, inflammatory bowel disease, and Parkinson&#8217;s disease. To study the function of the appendix, a gut disease-associated murine appendectomy model has been established and its step-by-step protocol is described here. This report introduces a facile protocol for caecal patch removal in mice followed by the chemical induction of chronic colitis-associated colorectal cancer using a combination of dextran sulfate sodium (DSS) and azoxymethane (AOM). IgA specific cells and IgA concentration were significantly reduced upon removal of the caecal patch in male C57BL/6 mice&#160;compared to those in the sham group. Simultaneously administering 2% DSS and AOM resulted in nearly 80% mice survival in both sham and appendectomy groups without significant body weight loss. Histological results confirmed colonic inflammation and different degrees of adenocarcinoma. This model can be used for the study of the functional role of the appendix in maintaining gut microbiota homeostasis and pathogenesis of gut colitis and malignancies, as well as for the potential development of drug targeting therapies.

The presented protocol describes a facile surgical removal of the appendix (caecal patch) in a mouse followed by the induction of inflammatory bowel disease-associated colorectal cancer. This murine appendectomy model enables investigation of the biological role of the appendix in the pathogenesis of human gastrointestinal disease.

慢性结肠炎相关结肠直肠癌的肿瘤切除术模型，通过卡卡贴片的精确定位

The human appendix has been recently implicated to play important biological roles in the pathogenesis of various complex diseases, such as colorectal ...

Establishing In Situ Closed Circuit Perfusion of Lower Abdominal Organs and Hind Limbs in Mice

Ex vivo perfusion is an important physiological tool to study the function of isolated organs (e.g. liver, kidneys). At the same time, due to the small size of mouse organs, ex vivo perfusion of bone, bladder, skin, prostate, and reproductive organs is challenging or not feasible. Here, we report for the first time an in situ lower body perfusion circuit in mice that includes the above tissues, but bypasses the main clearance organs (kidney, liver, and spleen). The circuit is established by cannulating the abdominal aorta and inferior vena cava above the iliac artery and vein and cauterizing peripheral blood vessels. Perfusion is performed via a peristaltic pump with perfusate flow maintained for up to 2 h. In situ staining with fluorescent lectin and Hoechst solution confirmed that the microvasculature was successfully perfused. This mouse model can be a very useful tool for studying pathological processes as well as mechanisms of drug delivery, migration/metastasis of circulating tumor cells into/from the tumor, and interactions of immune system with perfused organs and tissues.

A protocol is described for in situ perfusion of the mouse lower body, including the bladder, the prostate, sex organs, bone, muscle and foot skin.

在小鼠中建立下腹部器官和后肢的原点闭路灌注

Ex vivo perfusion is an important physiological tool to study the function of isolated organs (e.g. liver, kidneys). At the same time, due to the small ...

Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair

Laparoscopic incisional hernia repair using intraperitoneal onlay mesh (IPOM) is one of the most widely used minimally invasive methods for repairing incisional hernias. The laparoscopic IPOM involves implanting the mesh into the abdominal cavity through laparoscopy to repair an abdominal wall hernia. In the IPOM surgery, after the closure of the hernia ring, an anti-adhesion mesh is placed laparoscopically. The correct placement of this mesh is critical to the success of the method, and surgical skills are required to achieve perfect placement. If the mesh placement is not mastered properly, the operation and anesthesia time will be prolonged. In addition, improper placement of the mesh can lead to serious consequences, such as intestinal obstruction and mesh infection. A "contraposition and alignment" mesh fixation method is described in this study, which involves pre-marking the fixation position of the mesh to reduce the difficulty of mesh placement. A properly placed mesh is completely flat on the peritoneum, the edges are not curled or wrapped, and the mesh is adhered firmly such that there is no displacement after removing the pneumoperitoneum pressure. The "contraposition and alignment" mesh fixation technique offers the advantages of reliable placement of the mesh and fewer complications than other techniques, and it is easy to learn and master. It also allows for positioning the nail gun in advance based on the anatomy of the incisional hernia. This enables the use of the minimum number of nails possible while still ensuring good fixation, which can reduce the occurrence of complications and reduce the cost of surgery. Thus, the mesh fixation method described here is highly suitable for clinical applications based on the aforementioned advantages.

Presented here is a method for improving the mesh placement in laparoscopic incisional hernia repair, which can shorten the time required for mesh fixation and reduce the occurrence of postoperative chronic pain.

新型网片固定方法在腹腔镜切口疝修补术中的应用

Laparoscopic incisional hernia repair using intraperitoneal onlay mesh (IPOM) is one of the most widely used minimally invasive methods for repairing ...

Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis

Laparoscopic hepatectomy is a common treatment for colorectal cancer liver metastasis. Previously, a sufficient number of functional liver masses had to be maintained during laparoscopic hepatectomy, with a residual liver volume of &gt;40% in cirrhotic patients and &gt;30% in non-cirrhotic patients. The high incidence of complications such as bleeding, bile leakage, or liver failure due to the exposure and difficulty of the resection of specific liver segments such as S2 and S7 reduces the success rate of liver resection. At present, microwave ablation is mainly applied in the treatment of liver metastasis using a percutaneous approach, which makes it difficult to identify hidden parts or small lesions. For some liver segments, the percutaneous puncture of liver segment 7 (S7) is likely to pass through the thoracic cavity, and the percutaneous puncture of liver segment 2 (S2) adjacent to the diaphragm is likely to injure the diaphragm and heart; these issues restrict the application of percutaneous ablation in colorectal cancer liver metastasis. Considering multiple lesions, laparoscopic microwave ablation combined with hepatectomy was performed in this study. The location of the lesions was determined by contrast-enhanced ultrasound under laparoscopy, and small lesions that were difficult to detect before the operation were identified. For the scattered lesions, which had diameters less than 3 cm and were difficult to resect, ablation was adopted to substitute hepatectomy. This technique helped to more explicitly locate the tumors, simplified the operation procedures, reduced the risk of complications such as bleeding and bile leakage, shortened the operation time, accelerated the postoperative recovery, significantly improved the success rate of operation, and enhanced the clinical prognosis of colorectal cancer liver metastasis by surgical resection.

This protocol describes the laparoscopic resection of colorectal cancer liver metastases combined with ultrasound-guided microwave ablation. This technique can safely, effectively, and accurately treat refractory liver metastases &lt;3 cm, reduce postoperative complications, and accelerate the postoperative rehabilitation of patients.

腹腔镜肝切除术联合术中微波消融术在结直肠癌肝转移中的应用

Laparoscopic hepatectomy is a common treatment for colorectal cancer liver metastasis. Previously, a sufficient number of functional liver masses had to ...