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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Representative Results
  • Discussion
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

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.

Abstract

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.

Introduction

Obesity is an emerging and endemic situation with increasing prevalence, affecting approximately 1 in 20 adults worldwide1. Bariatric surgery has become the most effective treatment option for the affected adults in recent years, improving both weight loss and metabolic disorders2,3, with variable results depending on the type of surgical procedure used.

There are two main mechanisms that are implicated in the effects of the bariatric procedures: restriction that aims to increase satiety (such as in the sleeve gastrectomy (SG) where 80% of the stomach is remo....

Protocol

This protocol has been approved by the local French ethical committee for animal experimentation (Comité d'éthique en expérimentation animale; reference CEEA-PdL n 06).

1. Pre-operative preparation

  1. Add gel diet food to the normal diet 3 days before the surgery. Fast the mice 6 h before the surgery.
  2. Induce anesthesia with 5% isoflurane (1 L/min) in a dedicated chamber with oxygen (1 L/min). Inject the mice subcutaneously with buprenorphi.......

Representative Results

Learning curve
The learning curve for this model is displayed in Figure 6. A progressive decrease in the operating time is observed, reaching approximately 60 min of surgery after 4 weeks of intensive training (Figure 6A). The 5-day postoperative survival also improved with time, reaching 77% during regular practice (Figure 6B). The most frequent causes of mortality were anastomotic leaks and an afferent loop .......

Discussion

Bariatric surgeries, whose techniques are constantly evolving, appear to be currently the most effective treatment for obesity and associated metabolic comorbidities3,19,20. The SADI-S procedure, firstly described in 20074, is a promising procedure associated with greater metabolic effects than other malabsorptive surgeries. Animal models, particularly mice that allow the rapid generation of genetically m.......

Acknowledgements

We thank Ethicon (Johnson and Johnson surgical technologies) for kindly providing the suture cord and surgical clips. This work was supported by grants from the NExT Talent Project, Université de Nantes, CHU de Nantes.

....

Materials

NameCompanyCatalog NumberComments
Agagani needle 26 GTerumo050101B26 G needle
Betadine dermique Pharma-gdd3300931499787Povidone solution
Betadine scrubPharma-gdd 3400931499787Povidone solution
Binocular microscopeOptika Microscopes ItalySZN-9Binocular stereomicroscope
BuprecareAnimalcare3760087151244Buprenorphin
Castroviejo, straight 9 cmF.S.T12060-02Micro scissors
Castroviejo, straight 9 cmF.S.T12060-02Needle holder
Chlorure de sodium Fresenius 0.9%Fresenius Kabi BE182743NaCl 0.9%
ClamoxylMed'vet5414736007496Amoxicilline
Cotton budsComed2510805Cotton swabs
Element HT5ScilvetElement HT5Automated hematology analyzer
EmepridCEVA3411111914365Metoclopramid
Extra Fine Graefe Forceps, curved (tip width: 0.5 mm)F.S.T11152-10Surgical forceps
Extra Fine Graefe Forceps, straight (tip width: 0.5 mm)F.S.T11150-10Surgical forceps
FercobsangVetopriceQB03AE04Iron, multivitamins and minerals 
ForaneBaxter1001936060Isoflurane
Graefe forceps, straight (tip width: 0.8 mm)F.S.T11050-10Forceps
Graphpad Prism version 8.0GraphPad Software, Inc.Version 8.0Software for statistical analysis
Heat padIntellibio innovationA-2101-00300Heat pad
IncubatorBioconcept TechnologiesManufactured on demandIncubator 
LightingOptika Microscopes ItalyCL-30Lighting for microscopy
OcrygelMed'vet3700454505621Carboptol 980 NF
Pangen 2.5 cm x 3.5 cmUrgovetA02978Haemostatic collagen compress
Prolene 6/0B.Braun3097915Optilene 6/0 (0.7 metric) 75 cm 2XDR13 CV2 RCP, suture cord
Prolene 8/0Ethicon87322 x BV175-6 MP, 3/8 Circle, 8 mm,  suture cord
ScissorsF.S.T146168-09Surgical scissors
Sterile compresses Laboartoire Sylamed211S05-50Non-woven sterile compressed
Terumo SyringeTerumo508281 mL syringe
Titanium hemostatic clipPéters SurgicalB2180-1Surgical clip
Vannas WolffF.S.T15009-08Micro scissors
Vita RongeurVirbac3597133087611Vitamin supplementation
Vitaltec stainlessPéters SurgicalPB 220-EB MediumSurgical clip applier

References

  1. Flegal, K. M., Carroll, M. D., Kit, B. K., Ogden, C. L. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 307 (5), 491-497 (2012).
  2. Sjöström, L., et al.

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