We would like to acknowledge the funding contributions of the Canadian Surgical Research Fund, the Edmonton Civic Employees Research Assistance Fund, and the Alberta IBD Consortium through a grant from Alberta Innovates.

동물 사용 프로토콜은 알버타 대학의 건강 과학 동물 관리 및 사용위원회에 의해 승인되었습니다. 악기, 동물, 수술 설치 1. 준비 <ol><li> 절차 이전에 모든 고체 음식 24 시간의 새로운, 깨끗한 케이지 결석에 동물을 전송합니다. 그들은 절차의 시간 동안 물에 자유롭게 접근하고, 액체 다이어트 적량을 가질 수있다. </li><li> 절차에 필요한 모든 악기를 압력솥. 클린 운영면과 70 % 에탄올로 마취 코 콘. </li><li> 운영 외과 의사를위한 편안한 방식으로 운영 현미경, 마취 기계 및 소모품과 운영면을 설정합니다. 외과 의사의 팔꿈치는 손과 장비에 의해 방해받지 팔, 운영 테이블에 편안하게 휴식을 허용해야합니다. 악기, 봉합, 면봉, 그리고 10 ML의 주사기는 절차를 수행하는 동안 쉽게 액세스를 허용하는 위치에 배치해야합니다. </li><li> 설정열 헤드 램프는 조작면에 대한 절차와 빛이 동안 동물 용 온기를 모두 제공한다. </li><li> 0.9 % 식염수 50 ML 원뿔 튜브 및 운영 표면 근처 석유 젤리 및 장소 1.5 ML 튜브를 입력합니다. 참고 : 모든 악기와 수술 용품을 소독. 소장이 가로로되어 있기 때문에, 절차 자체 멸균 아니다. 그것은 깨끗하고 오염 된 것으로 간주됩니다. 감염의 외생 소스의 도입을 방지 할 수있는 조치를 취하십시오. </li></ol> 문합 2. Ileocolic 절제술 <ol><li> 동물의 호흡 속도가 약 30 내지 40 호흡 / 분까지 저하 이소 플루 란 기화기로부터 노즈콘을 통해 / 분 2 L의 산소 유량을 갖는 4 % 이소 플루 란을 투여하여 마취를 유도한다. 절차를 시작하기 전에 고통의 응답이없는 보장하기 위해 마우스의 뒷발에 적당한 압력을 적용합니다. 이 시점에서, / 분으로 0.5 L로 2 % 이소 플루 란과 산소 흐름을 거절. 간헐적으로절차 동안 통증 반응을 확인하고 그에 따라 이소 플루 유량을 조정한다. </li><li> 수술 중 건조를 방지하고, 투명 테이프를 사용하여 보호 사지와 부정사 위치에 마우스를 고정하기 위해 눈에 바셀린을 적용합니다. </li><li> povodine / 요오드 용액으로 복부를 청소하고, 새로운 멸균 장갑으로 변경합니다. </li><li> 근막과 복막을 노출 가위를 해부 날카로운 포인트를 사용하여 복부의 상단 중간 선에서 1.5 cm의 피부 절개를합니다. 복막 내용을 노출하는 원격 교육의 알바를 통해 비슷한 방식으로 근막 / 복막 계층을 엽니 다. </li><li> 인간 대조적으로, 마우스는 일반적으로 맹장 복부 좌상 사분면에 발견된다. 확인되면, 부드럽게 집게로 맹장을 잡고 절개를 통해 제공합니다. 팬에 적신 면봉을 사용하여 밖으로 약 복부 표면 (그림 1A)에 드리 워진 멸균 거즈를 통해 맹장에서 연장 회장 말단의 3cm.노출 된 창자가 절차의 전체 중 0.9 % 식염수와 습기가 유지되어 있는지 확인합니다. </li><li> 운영 현미경을 사용하여 콜론 (그림 1A)를 따라 상 장간막 동맥 떨어져 분기 회맹 동맥을 확인합니다. , 회맹 동맥에 인접한 무 혈관 조직을 해부 둘러싸고 5-0 실크 넥타이와 동맥을 결찰. 다음으로, 회장 말단에 지역 혈액 공급을 찾아 회맹 접합에 절개 포인트 1.5 형상 관리 근위을 선택합니다. 위와 회장의이 부분에 가지를 결찰. 마이크로 가위를 해부와 동맥을 나눈다. </li><li> 가로로 끝 (그림 1B)에 충분한 혈액 공급이 보장 회장과 대장의 ​​허혈성 부분을 나눈다. 그것은 더 밀접하게 일치하도록 결장 내강의 직경을 증가시키기 위해 30도 각도로 분할하여 회장을 주걱 것이 종종 도움이된다. 창자 회맹 부분이 제거 된 후, 정렬각각의 장간막 국경을 보장 거즈에 회장과 대장의 가로로 끝이 정렬됩니다. </li><li> 사용 대장의 가로로 마지막에 회장의 가로로 끝을 근사하여 문합 구축은 8-0 폴리 프로필렌 봉합사 (그림 1C)를 중단. Ileocolic 문합은 방수가 될 때까지 이후의 봉합은 모든 0.5 mm를 배치와 함께 첫 번째 스티치, 장간막 국경에 배치됩니다. 회장과 대장을 통해 봉합 바늘을 통과하는 경우, 절단 된 모서리가 롤백되지 않도록하고, 바늘 물린 대장의 절단면에서 0.5 mm입니다. 전형적인 문합은 14-16 중단 봉합이 필요합니다. 문합을 통해 내용을 강제로 회장을 통해 원위 면봉 근위 롤링에 의해 완료시 문 합부의 무결성과 개통을 테스트합니다. 소장의 내용은 자유롭게 문 합부 누출없이 대장에 전달해야합니다. </li><li> 10 ML의 주사기에서 0.9 % 식염수 3-4 mL를 노출 창자를 씻어대장의 표면에서 대변을 씻어하고, 복강에 다시 장을 제공합니다. 0.9 % 식염수 2 ㎖를 사용하여 복강 씻은 다음 횡 복벽에 약간 힘을인가하여 유체를 배수. </li><li> 3-0 실크 실행 봉합과 절개를 닫고, 이소 플루 란의 흐름을 중단. 수술 후 통증 조절을 위해 -buprenorphine- 피하 긴 작용하는 아편의 0.1 ㎎ / ㎏을 관리합니다. </li><li> 그들은 다음 이동성 지속적으로 따뜻하게 케이지로 전송 될 때까지 가열 램프 아래에있는 동물을 관찰한다. </li></ol> 3. 수술 후 관리 및 모니터링 <ol><li> 하루의 나머지 부분에 대한 고민의 흔적이 지속적으로 따뜻하게 새장에 동물을 모니터링합니다. 액체 다이어트와 물 적량에 액세스 할 수있는 새로운 멸균 케이지 다시 동물 보호 시설에 동물을 전송합니다. 동물은 3-4 그룹에 수납 할 수있다. </li><li> 다음날 아침 수술 후 동물 검사를 수행,동물이 고통에 표시되지 않도록. 만 액체 음식을 공급. 그들이 불편 (즉, 웅크 자세 또는 최소한의 활동을) 표시되면 피하 부 프레 노르 핀의 추가 용량을 관리 할 수 있습니다. 수술 후 1 일에 오후에 한 번 더 동물에 확인합니다. </li><li> 수술 후 2 일째의 아침에 동물이 완전히 회복 나타납니다. 음식 소비와 stooling의 증거는 회복의 긍정적 인 신호이다. 자, 동물 용 고체 차우 다이어트를 다시 시작합니다. 참고 : 고통의 징후가 웅크 자세, 가난한 정리, 최소한의 활동을 포함한다. 고통의 흔적이 눈에 띄는 경우 동물은 안락사되어야한다. </li><li> 동물까지 2 L / 분의 O 2 유량 4 % 이소 플루 란 깊은 마취를 유도함으로써 동물을 안락사는 족압에 응답한다. 경추 탈구를 수행하고 적절한 euthanization의 흔적을 관찰합니다. </li><li> 가이드 라인은, 그래서 표시에 관한 기관의 권고 사항을 참조 달라및 마우스에 euthanization의 적절한 방법. </li></ol>

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The authors have nothing to disclose

뮤린 ICR는 장 질환 수술의 효과를 연구하기 위해 사용될 수있는 강력한 모델이다. 이 기사는 95 %의 성공률과 업 시술 후 이십팔일 안정 가중치 반영된 번창 부전 문제없이 ICR 마우스에서 수행 방법을 설명한다. 성공적인 ICR에 가장 중요한 과제는 문합과 문 합부 누출에 장 장애물을 피하는 등이 있습니다. 폐색을 방지하기위한 수술 기술 요소는 문합에 내강 직경을 최대화위?...

Ileocolic resection (ICR) is a common procedure performed in both emergent and elective situations for a variety of illnesses. Crohn&#8217;s disease and colon cancers are the two most common indications for ICR. In both illnesses, recurrence in the bowel at the site of surgery represents a major clinical problem. Local recurrence rates for colon cancer remain an issue even with the most aggressive resections1. Following ICR in Crohn&#8217;s disease, the disease most frequently (in up to 80%) recurs in the neo-terminal ileum at 1 year after surgery2. Given the impact of these two illnesses and their recurrence after surgery, it is important to understand local intestinal factors after ICR, which may have intrinsic influences on the natural history of these diseases. Further, it is also important to consider anastomotic healing after ICR. In the early post-operative period, anastomotic leaks can have devastating consequences for patients resulting in repeat surgeries, stoma creations, significant morbidity, and even mortality3. Despite the importance of this topic, our current understanding of anastomotic healing remains in its infancy as a subject of research. Animal models of ICR, in particular mice, are an excellent platform for studying the intestinal and anastomotic healing following surgery.
A mouse model of ICR was initially developed by Helmrath et al. to be used as a model of short gut syndrome4. The authors experimented with various diet regiments and suture sizes to optimize animal survival following ICR. They concluded that feeding with liquid diet in the perioperative period and using 9-0 monofilament sutures resulted in an optimal post-operative survival of 88%. Since this initial publication, ICR in mice removing 50% of the small bowel has been used in several studies to explore the dynamics of massive small bowel resection and the adaptive growth response in attempt to develop new therapies for short gut syndrome5,6.
The first application of the ICR mouse model to Crohn&#8217;s disease used the IL-10-/- mouse model, which spontaneously develops colitis7. The authors found that after ICR these animals developed inflammation in the neo-terminal ileum similar to that seen in post-operative Crohn&#8217;s disease patients, and that this inflammation was dependent on the presence of bacteria7. More recently, this model was used to explore bacterial changes induced by ICR. In Crohn&#8217;s disease there is an associated dysbiosis with relative decreases in bacteria known to have anti-inflammatory properties and increases in invasive species of bacteria8,9. The association holds true in cases of post-operative recurrence10. Two studies sought to identify microbial changes resulting from ICR. The first used IL-10 null mice, and performed denaturing gel electrophoresis to compare bacterial similarity between the small bowel and colon after ICR11. This study demonstrated that bacterial populations became similar in the small intestine and colon following ICR. A subsequent study used wild type mice and 16s pyrosequencing for phylogenetic classification of bacterial species post-operatively. This study demonstrated a marked shift in bacterial species resulting from surgery alone with Clostridium species becoming dominant as well as an increase in &#978;-proteobacteria. The results also confirmed the findings of the previous study with similar populations found in the small bowel and colon after ICR12. 
ICR is a common procedure for patients with colon cancer involving the cecum and ascending colon, and it is becoming increasingly recognized that the host-response to surgery likely contributes to both local and distant tumor recurrence13. Despite this observation, models of ICR have not been utilized for the study of colorectal cancer and post-operative recurrence. Understanding both the systemic and local immunologic changes resulting from ICR will be important in investigating future therapies. Potential pathways involved in cancer recurrence post ICR include up regulation of growth factors, which may rescue cells from apoptosis and stimulate proliferation, mechanical tumor disruption with cell shedding, and loss of immune surveillance through post-operative immunosuppression13,14. 
Mouse models of ICR have the potential to be a powerful tool for the investigation of short bowel syndrome, Crohn&#8217;s disease, and colon cancer. They may also provide lessons on how to prevent early post-operative anastomotic complications by further defining the cellular and biochemical pathways involved in healing the newly constructed anastomosis. A major barrier in utilizing the murine ICR model is the technical difficulty. The intestinal anastomosis requires the use of 8-0 or 9-0 suture, an operating microscope, and training in microsurgical techniques. The goal of this article is to provide clear instructions on how to perform ICR in mice with the goal of utilizing this procedure in models of disease.

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murine ileocolic bowel resection with primary anastomosis

Intestinal resections are frequently required for treatment of diseases involving the gastrointestinal tract, with Crohn&#8217;s disease and colon cancer being two common examples. Despite the frequency of these procedures, a significant knowledge gap remains in describing the inherent effects of intestinal resection on host physiology and disease pathophysiology. This article provides detailed instructions for an ileocolic resection with primary end-to-end anastomosis in mice, as well as essential aspects of peri-operative care to maximize post-operative success. When followed closely, this procedure yields a 95% long-term survival rate, no failure to thrive, and minimizes post-operative complications of bowel obstruction and anastomotic leak. The technical challenges of performing the procedure in mice are a barrier to its wide spread use in research. The skills described in this article can be acquired without previous surgical experience. Once mastered, the murine ileocolic resection procedure will provide a reproducible tool for studying the effects of intestinal resection in models of human disease.

사망률과 체중 변화 수술 후. 129S1 야생형 생쥐에서 ICR을 다음과 사망률 ~ 5 % 일반적이다. 도덕의 가장 일반적인 원인은 문합에서 장폐색입니다. 사망의 다른 원인은 문 합부 누출과 폐쇄를 창자로 이어지는 내부 탈장을 포함한다. 체중 감소는 수술 후 최대 14 일까지 볼 수 있지만, 일반적으로 비 중요하다 할 수있다. 마우스는 완전히 수술 후 28 일째 (그림 2)...

Watch this Scientific Journal Video about Murine Ileocolic Bowel Resection with Primary Anastomosis at JoVE.com

Murine Ileocolic Bowel Resection with Primary Anastomosis

Ileocolic resection is commonly performed in several human diseases; however, little is known regarding the impact of intestinal resection on surgical illnesses. This article provides instruction on executing the procedure in mice with high success, providing a means to study the effects of ileocolic resection in models of disease.

차 문합와 쥐의 Ileocolic 대장 절제술

Intestinal resections are frequently required for treatment of diseases involving the gastrointestinal tract, with Crohn&#8217;s disease and colon cancer ...

murine-ileocolic-bowel-resection-with-primary-anastomosis

Research

JoVE Journal

Medicine

16.2K 조회수.  University of Alberta. Ileocolic resection is commonly performed in several human diseases; however, little is known regarding the impact of intestinal resection on surgical illnesses. This article provides instruction on executing the procedure in mice with high success, providing a means to study the effects of ileocolic resection in models of disease.

비디오: Murine Ileocolic Bowel Resection with Primary Anastomosis

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

Colorectal anastomotic leakage (AL) is a serious complication in colorectal surgery leading to high morbidity and mortality rates1. The incidence of AL varies between 2.5 and 20% 2-5. Over the years, many strategies aimed at lowering the incidence of anastomotic leakage have been examined6, 7. 
The cause of AL is probably multifactorial. Etiological factors include insufficient arterial blood supply, tension on the anastomosis, hematoma and/or infection at the anastomotic site, and co-morbid factors of the patient as diabetes and atherosclerosis8. Furthermore, some anastomoses may be insufficient from the start due to technical failure.
Currently a new device is developed in our institute aimed at protecting the colorectal anastomosis and lowering the incidence of AL. This so called C-seal is a biofragmentable drain, which is stapled to the anastomosis with the circular stapler. It covers the luminal side of the colorectal anastomosis thereby preventing leakage.
The C-seal is a thin-walled tube-like drain, with an approximate diameter of 4 cm and an approximate length of 25 cm (figure 1). It is a tubular device composed of biodegradable polyurethane. Two flaps with adhesive tape are found at one end of the tube. These flaps are used to attach the C-seal to the anvil of the circular stapler, so that after the anastomosis is made the C-seal can be pulled through the anus. The C-seal remains in situ for at least 10 days. Thereafter it will lose strength and will degrade to be secreted from the body together with the gastrointestinal natural contents.
The C-seal does not prevent the formation of dehiscences. However, it prevents extravasation of faeces into the peritoneal cavity. This means that a gap at the anastomotic site does not lead to leakage.
Currently, a phase II study testing the C-seal in 35 patients undergoing (colo-)rectal resection with stapled anastomosis is recruiting. The C-seal can be used in both open procedures as well as laparoscopic procedures. The C-seal is only applied in stapled anastomoses within 15cm from the anal verge. In the video, application of the C-seal is shown in an open extended sigmoid resection in a patient suffering from diverticular disease with a stenotic colon.

The C-seal is a biofragmentable drain protecting the stapled colorectal anastomosis. In this video, details of the manufacturing, deployment and use are shown.

C - 인감 : 누출에서 잘라 대장암 문합 보호 Biofragmentable 드레인

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

연구

의학

Orthotopic Small Bowel Transplantation in Rats

Small bowel transplantation has become an accepted clinical option for patients with short gut syndrome and failure of parenteral nutrition (irreversible intestinal failure). In specialized centers improved operative and managing strategies have led to excellent short- and intermediate term patient and graft survival while providing high quality of life 1,3. Unlike in the more common transplantation of other solid organs (i.e. heart, liver) many underlying mechanisms of graft function and immunologic alterations induced by intestinal transplantation are not entirely known6,7. Episodes of acute rejection, sepsis and chronic graft failure are the main obstacles still contributing to less favorable long term outcome and hindering a more widespread employment of the procedure despite a growing number of patients on home parenteral nutrition who would potentially benefit from such a transplant. The small intestine contains a large number of passenger leucocytes commonly referred to as part of the gut associated lymphoid system (GALT) this being part of the reason for the high immunogenity of the intestinal graft. The presence and close proximity of many commensals and pathogens in the gut explains the severity of sepsis episodes once graft mucosal integrity is compromised (for example by rejection). To advance the field of intestinal- and multiorgan transplantation more data generated from reliable and feasible animal models is needed. The model provided herein combines both reliability and feasibility once established in a standardized manner and can provide valuable insight in the underlying complex molecular, cellular and functional mechanisms that are triggered by intestinal transplantation. We have successfully used and refined the described procedure over more than 5 years in our laboratory 8-11. The JoVE video-based format is especially useful to demonstrate the complex procedure and avoid initial pitfalls for groups planning to establish an orthotopic rodent model investigating intestinal transplantation.

Small bowel transplantation has become an accepted treatment option for patients with irreversible intestinal failure. Our experimental model of orthotopic small bowel transplantation in rats serves as a reliable tool to address underlying immunologic and inflammatory processes that complicate intestinal transplantation.

쥐 Orthotopic 작은 창자 이식

Small  bowel transplantation has become an accepted clinical option for patients with  short gut syndrome and failure of parenteral nutrition ...

Application of End-to-end Anastomosis in Robotic Central Pancreatectomy

Central pancreatectomy is carried out for the treatment of benign or low-malignant potential tumors located in the pancreatic neck or proximal part of pancreatic body. With technological development, the robotic surgical system has shown its advantage in minimally invasive surgery and been increasingly applied in central pancreatectomy. However, reconstruction of the continuity of pancreas with end-to-end anastomosis after robotic central pancreatectomy has not been applied. In this study, we report surgical techniques for robotic central pancreatectomy with end-to-end anastomosis. The pancreas is reconstructed by duct-to-duct anastomosis of the pancreatic duct with a pancreatic stent inserted in the two stumps of pancreatic duct, and by end-to-end anastomosis of the pancreatic parenchyma. Compared with traditional central pancreatectomy with pancreaticoenteric anastomosis, this approach decreases the operative injury to the patient, and also conserves the integrity and continuity of the digestive duct and pancreatic duct. The robotic surgical system integrated with multiple instruments with flexible and precise movement is particularly suitable for the dissection and reconstruction of the pancreatic duct. We found that robotic central pancreatectomy with end-to-end anastomosis is safe and feasible, and we need more experience to evaluate its best indications and long-term outcomes.

The robotic central pancreatectomy with end-to-end anastomosis is feasible and safe for tumor in the pancreatic neck and proximal portion of pancreatic body. The operative techniques of this operation are presented.

로봇 중앙 Pancreatectomy 문 합 엔드 투 엔드의 응용 프로그램

Central pancreatectomy is carried out for the treatment of benign or low-malignant potential tumors located in the pancreatic neck or proximal part of ...

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Endoscopic septoplasty is a surgical procedure in otolaryngology that is commonly performed to treat nasal airway obstruction caused by nasal septal deviation. It has a long history with multiple variations. In this article, a modified endoscopic septoplasty procedure using the limited two-line resection (2LoRs) technique at the posterior and inferior junction of the cartilaginous and bony septum is presented based on embryologic and anatomic knowledge of the nasal septum and the biomechanics of cartilaginous behavior. With this procedure, the quadrangular cartilage can be preserved as much as possible, which is helpful in retaining the supporting framework and rigidness of the septum. 2LoRs has been proven effective and sound for the correction of nasal septal deviation with rare complications. This modified procedure can be applied to correct the deviated nasal septum in the absence of any external nasal deformity to improve nasal patency or to improve access to the middle meatus or to the axillary region of the middle turbinate. It may also be used to expand the indications of septoplasty to children and adolescents because of its minimally invasive approach.

Endoscopic septoplasty is a time-honored surgical procedure with multiple variations. This paper focuses on a step-by-step surgical approach to perform a modified septoplasty procedure known as limited two-line resection. This surgical technique can be applied to correct a deviated nasal septum in the absence of an external nasal deformity.

Endoscopic septoplasty is a surgical procedure in otolaryngology that is commonly performed to treat nasal airway obstruction caused by nasal septal ...

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.

선박을 살려주는 절단 및 기본 문 합

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.

쥐에 있는 저 승 문 합의 창조

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.

쥐에서 한 문 합 위 우회 (OAGB)

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 ...

Studying Murine Small Bowel Mechanosensing of Luminal Particulates

Gastrointestinal (GI) motility is critical for normal digestion and absorption. In the small bowel, which absorbs nutrients, motility optimizes digestion and absorption. For this reason, some of the motility patterns in the small bowel include segmentation for mixing of luminal contents and peristalsis for their propulsion. Physical properties of luminal contents modulate the patterns of small bowel motility. The mechanical stimulation of GI mechanosensory circuits by transiting luminal contents and underlying gut motility initiate and modulate complex GI motor patterns. Yet, the mechanosensory mechanisms that drive this process remain poorly understood. This is primarily due to a lack of tools to dissect how the small bowel handles materials of different physical properties. To study how the small bowel handles particulates of varying sizes, we have modified an established in vivo method to determine small bowel transit. We gavage live mice with fluorescent liquid or tiny fluorescent beads. After 30 minutes, we dissect out the bowels to image the distribution of fluorescent contents across the entirety of the GI tract. In addition to high-resolution measurements of the geometric center, we use variable size binning and spectral analysis to determine how different materials affect small bowel transit. We have explored how a recently discovered "gut touch" mechanism affects small bowel motility using this approach.

To study how the small bowel handles particulates of varying sizes, we have modified an established in vivo method to determine small bowel transit.

내강 미립자의 쥐 소장 기계 감지 연구

Gastrointestinal (GI) motility is critical for normal digestion and absorption. In the small bowel, which absorbs nutrients, motility optimizes digestion ...

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity

Old compression vertebrae fracture or congenital kyphoscoliosis with abnormal vertebral body development and other diseases that invade the spine may cause severe thoracolumbar kyphotic deformity, often accompanied by intractable low back pain or compression of the spinal cord, leading to severe neurological symptoms or even paralysis. If conservative treatment cannot relieve the symptoms or correct the deformities, surgical treatment is usually needed. For severe kyphotic deformity, reconstruction of the physiological curvature and rigid fixation determine the prognosis of the patients. Osteotomy and orthopedics are the standard procedure for deformities with severe compression of the front and middle column, but the trauma to the patients is high, with a long operation time and massive blood loss. To avoid these disadvantages, we have developed a modified technique to remove the diseased vertebra unilaterally. In this technique, we use a modified trephine to resect the vertebral columns like in the pedicle screw technique by adding a locking instrument that can restrict the trephine to lower the risk of osteotomy and shorten the surgery time and blood loss.

We describe a modified technique for resecting the posterior vertebral column unilaterally based on a modified trephine for patients with thoracolumbar kyphotic deformity.

흉요추 후만 기형 환자를 위한 수정된 후방 척추 기둥 절제술

Old compression vertebrae fracture or congenital kyphoscoliosis with abnormal vertebral body development and other diseases that invade the spine may ...

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.

생쥐의 단일 문합 십이지장-회장 우회술(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 ...