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Creation of Abdominal Adhesions in Mice

Published: August 27th, 2016



1Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine

Abdominal adhesions that form after surgery are a major cause of pain, infertility, and hospitalization and reoperation for small bowel obstruction. Our surgical procedure for creating abdominal adhesions in mice is a reliable tool to study the mechanisms underlying the formation of adhesions.

Abdominal adhesions consist of fibrotic tissue that forms in the peritoneal space in response to an inflammatory insult, typically surgery or intraabdominal infection. The precise mechanisms underlying adhesion formation are poorly understood. Many compounds and physical barriers have been tested for their ability to prevent adhesions after surgery with varying levels of success. The mouse and rat are important models for the study of abdominal adhesions. Several different techniques for the creation of adhesions in the mouse and rat exist in the literature. Here we describe a protocol utilizing abrasion of the cecum with sandpaper and sutures placed in the right abdominal sidewall. The mouse is anesthetized and the abdomen is prepped. A midline laparotomy is created and the cecum is identified. Sandpaper is used to gently abrade the surface of the cecum. Next, several figure-of-eight sutures are placed into the peritoneum of the right abdominal sidewall. The abdominal cavity is irrigated, a small amount of starch is applied, and the incision is closed. We have found that this technique produces the most consistent adhesions with the lowest mortality rate.

Abdominal adhesions are a form of scar tissue that form in the abdomen in response to inflammation, typically following surgery or intraabdominal infection. Adhesions are a major cause of chronic abdominal pain and infertility, and are the most common cause of small bowel obstruction1. The presence of adhesions makes performing a second abdominal operation more difficult and increases the likelihood of complications2.

Despite years of research, the mechanisms underlying the formation of adhesions remain poorly understood. It is known that an initial injury to the peritoneal surface causes an exudation of fibrin-rich fl....

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The following protocol has been approved by the Stanford University Institutional Animal Care and Use Committee (IACUC) and complies with all institutional ethical guidelines regarding the use of research animals.

1. Creation of Abdominal Adhesions

  1. Start the mouse on antibiotic chow diet one week prior to the procedure.
  2. Autoclave the surgical instruments and pre-warm the saline irrigation solution.
  3. Anesthetize the mouse using 2% inhaled isoflurane.
  4. Usi.......

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At seven days after surgery, the cecum and possibly ascending colon, liver, and loops of small bowel should be adherent to the right-sided abdominal wall. (Figure 8) Excised tissue can be embedded and sectioned and will yield excellent histological slides. (Figure 11, 12)

When the procedure is performed properly, 100% of mice should have substantial adhesions at seven days. Mortality should be l.......

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The critical steps in this procedure are: thoroughly abrading the cecum without causing perforation, placing sutures in the abdominal sidewall, and applying the right amount of starch. Only apply sandpaper to the cecum, or to a small specific portion of the bowel. Wide use of sandpaper on large amounts of small bowel tends to cause significant ileus. Take care to abrade the cecum with enough force that the surface becomes rough, but not so much that the wall tears. Finding this balance can take some time. Always handle t.......

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C.D.M. was supported by the American College of Surgeons (ACS) Resident Research Scholarship. M.S.H. was supported by the California Institute for Regenerative Medicine (CIRM) Clinical Fellow training grant TG2-01159. M.S.H., H.P.L., and M.T.L. were supported by the American Society of Maxillofacial Surgeons (ASMS)/Maxillofacial Surgeons Foundation (MSF) Research Grant Award. H.P.L. was supported by NIH grant R01 GM087609 and a gift from Ingrid Lai and Bill Shu in honor of Anthony Shu. H.P.L. and M.T.L. were supported by the Hagey Laboratory for Pediatric Regenerative Medicine and The Oak Foundation. M.T.L. was supported by the Gunn/Olivier Fund.


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Name Company Catalog Number Comments
Fisherbrand Absorbent Underpads, 20" x 24" Fisher Scientific 14-206-62
Polylined Sterile Field, 18" x 24" Busse Hospital Disposables 696 Cut a rectangular hole of the appropriate size
Isothesia isoflurane Henry Schein  050033
Fisherbrand Sterile cotton gauze pad, 4" x 4" Fisher Scientific 22-415-469
Puralube petrolatum ophthalmic ointment, 1/8 oz. tube Dechra Veterinary Products NDC 17033-211-38
Nair depilatory cream Church & Dwight Co. 22339-05
Buprenex buprenorphine  0.3 mg/mL Reckitt Benckiser Pharmaceuticals Inc. NDC 12496-0757-5
1 cc insulin syringe, 27G Becton  Dickinson 329412
Povidone Iodine Prep Solution Medline MDS093944H
Webcol alcohol prep swabs Covidien 6818
General-Purpose Labarotory Labeling tape VWR 89097-912
BioGel PI surgical gloves Mölnlycke Health Care ALA42675Z
Micro Forceps with teeth Roboz RS-5150
Fine scissors- sharp Fine Science Tools 14060-09
Straight serrated forceps Fine Science Tools 11050-10
Castro-Viejo needle driver Fine Science Tools 12565-14
100 grit 1/4 sheet sandpaper ACE Hardware 1010446 Cut into strips
4-0 silk suture, 30", SH needle Ethicon K831
7-0 PDS II absorbable monofilament suture, 30", BV-1 needle Ethicon Z135 Usually comes double-armed. Cut the suture at the midway point to generate two usable sutures.
Rice starch MP Biomedicals 102955
0.9% Sodium Chloride Irrigation Baxter BHL2F7121 Warm to 37° C prior to use
10 mL syringe Becton Dickinson 309604
6-0 Vicryl absorbable braided suture, 18", RB-1 taper needle Ethicon J212H
6-0 Ethilon nylon monofilament  suture, 18", P-3 needle,  Ethicon 1698G
Tegaderm Transparent Film Dressing Frame Style, 6 cm x 7 cm 3M 1624W Cut in half lengthwise

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