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.

Hayvan ve konut: 8 haftalık C57BL / 6 erkek fareler elde edin. yağdan% 35 kcal,% 25.8 kazein,% 1,30 mineral AIN, 1.30% vitaminleri,% 1.70 kalsiyum fosfat, 0.7: 10 haftalık iken suya C57BL / 6 fareler ücretsiz erişim ve yüksek yağlı diyet (DIO diyet vermek % kalsiyum karbonat,% 2.10 sitrat, potasyum, 0.026% kolin bitartrat,% 8.9 sükroz, 0.384% sistin,% 6.5 selüloz,% 31.7 domuz yağı,% 3.3 soya fasulyesi yağı ve% 16.29 maltodekstrin) 8 (SG), 14 (RYGB) hafta obezite ameliyatları öncesinde. kilo alımını teşvik etmek için RYGB cerrahi (sham RYGB) içeren su% 20 fruktoz adanmış fareler elde (a / h), yüksek yağlı diyet ilave olarak. Etik Beyanı: Aşağıda açıklanan tüm protokol adımları Hayvan Deneyleri Etik Kurulu yönergeleri izleyin ve onay numarası 01.953,01 altında Pays de la Loire. 1. Genel Preoperatif Hazırlık <ol><li> Ameliyat öncesi 6 saat süreyle fareler hızlı. jel diet yemek 3 gün ameliyat öncesi cerrahi ve sadece bir gün önce verildi. (0.4 L / dk dioksijen),% 5 izofluran (0.4 L / dak) ve O 2 olan bir oda içinde anestezi neden. Anesthetization etkili olduğunu doğrulamak için bir ayak-tutam testi yapın. Deri altı enjeksiyonu vasıtasıyla analjezik (0.1 mg / kg buprenorfin), antibiyotikler (10 mg / kg marbofloxacine) ve pro-kinetiği (1 mg / kg metoklopramid) uygulayınız. </li><li> (Laboratuvar trafik ve havalandırma fanları uzak) cerrahi işlemler için belirli bir çalışma alanı tahsis. adanmış sert yüzey dezenfektanları ile cerrahi alanı temizleyin. Ameliyat sırasında fare homeothermy korumak için çalışma alanı alana bir ısıtma yastığı yerleştirin. ısıtma pedi üzerinde temiz, emici underpad uygulayın. </li><li> Elektrikli tıraş makinesi kullanarak leğeni için sternum karın Tıraş. Sterilize plastik wrap (Şekil 1A ve 2A) fare karın sarın ve ısıtma p yatar pozisyonda fare yerleştirinreklam. </li><li> anestezi altında iken kuruluğunu önlemek için gözleri veteriner merhem sürün. Burun konisi fare yerleştirin ve% 2 izofluran (0.4 L / dak) ve O 2 (/ dk 0.4 L) ile anestezi korumak. </li><li> Ameliyat başlamadan önce, steril muayene elbisesi, tek kullanımlık scrubs kap, bir yüz maskesi ve steril eldiven giy. Tüm cerrahi adımlar için gerekli olan bir steril cerrahi alet seti içeren bir otoklava paketi açın. sterilize plastik wrap bir pencere kesin ve 2 ardışık povidon-iyodin çözümlerle cildi dezenfekte edin. </li></ol> 2. Kol gastrektomi: Cerrahi Prosedür <ol><li> Karın orta (Şekil 1B) <ol><li> binoküler mikroskop altında ve bir neşter ile, karın boşluğuna (karın kasları zarar vermeyin) açmak için karın ortasına kadar sternum bir orta hat kesi yapmak. 37 ° C tuzlu su çözeltisi ile ıslatılmış steril kompres ile cildi korumak. </li></ol></li><li> Mide poz (Şekil 1C) <ol><li> Yavaşça nemlendirilmiş pamuklu çubuklarla kullanarak mide seferber. nemli bir pamukla veya mikro makas kullanarak yanal yakın bağ dokusu ekleri mide ücretsiz. </li><li> Yavaşça, tam mide dışa ve hemostatik kollajen mide arkasına sıkıştırmak yerleştirin. (Şekil 1D ve E) kanama geleceği önlemek için 8.0 olmayan emilebilir dikişlerle mide büyük eğrilik boyunca pilor ve yemek borusu damarları dikilmelidir. Not: Hemostat kullanımı, doku hasarına neden sadece rezeke edilecek amaçlayan doku üzerinde kullanmak için emin olabilirsiniz. </li></ol></li><li> Midenin kardiyak bölgenin rezeksiyonu (fundus) <ol><li> Pilor bölgesi (corpus) ve mide (fundus) kardiyak bölge (Şekil 1F) arasındaki anatomik çizgi mevcut bir gastrotomi gerçekleştirin. </li><li> Her doğru 2 nemli bir pamukla kalan yiyecekleri çıkarınmide yan. Mikro makas kullanarak, fundus ve mide (Şekil 1G) külliyatının arasındaki sınır boyunca mide kesti. </li><li> hemostatik kollajen majör kanama durumunda 2 dakika süreyle sıkıştırmak basın. Insizyon (Şekil 1H) sonuna kadar mide-özofagus kavşağına 8.0 olmayan emilebilir dikişlerle mide ağzını kapatınız. </li></ol></li><li> Midenin pilor bölgenin rezeksiyonu (corpus) <ol><li> Mide (Şekil 1 H), yaklaşık% 80 bertaraf edilmesi için büyük bir kavis boyunca mide rezeksiyonu tamamlayın. 3 mm SG genişliğini standart hale getirilmiştir. hemostatik kollajen majör kanama durumunda 2 dakika süreyle sıkıştırmak basın. </li><li> 8.0 emilemeyen sütür (Şekil 1J) ile midenin pilor bölgesi açılmasını kapatın. Yavaşça dikiş sızdırmaz olmasını sağlamak için midenin her tarafına doğru 2 nemli bir pamukla yuvarlayın. </li><li>sızıntı durumunda 8.0 olmayan emilebilir dikişlerle tamamlayın. hemostatik kollajen kompresler çıkarın ve karın boşluğuna mide dönün. sütür karşı sıkıştırmak hemostatik kollajen bırakın. </li></ol></li><li> karın kapatma <ol><li> 5.0 olmayan emilebilir dikişlerle (Şekil 1K) ile karın duvarı kas tabakası kapatın. % 1 izofluran konsantrasyonu azaltarak anestezi azaltın. 5.0 olmayan emilebilir sütürler (Şekil 1L) kullanarak cilt kapatın. </li></ol></li></ol> 3. Roux-en-Y Gastrik Bypass: Cerrahi Prosedür <ol><li> karın orta <ol><li> binoküler mikroskop altında ve bir neşter ile, karın boşluğuna (karın kasları zarar vermeyin) açmak için karın ortasına kadar sternum bir orta hat kesi yapmak. 37 ° C tuzlu su solüsyonu (Şekil 2B) ile ıslatılmış steril bir kompres ile cildi korumak. </li></ol> &lt;/ Li&gt; <li> Biliopankreatik ekstremite ve sindirim ekstremite <ol><li> Bağırsak (Şekil 2C) dışa. Tedbir 8 Pilerden cm ve 5.0 olmayan emilebilir dikişlerle (Şekil 2B) ile bağırsak iki bitişik harfler gerçekleştirin. </li><li> İki bitişik harfler (Şekil 2E) arasında bağırsak kesti. karnın sol üst kadranda iki ucu proksimal ekstremite yerleştirin. Not: Bu sindirim bacak (Şekil 2F) olarak kullanılacaktır. </li><li> Sindirim ekstremite proksimal ekstremite (Şekil 2F) altında 6 cm bakan iki ucu distal ekstremite yerleştirin. Not: Bu safra bacak olarak kullanılacaktır. </li></ol></li><li> Jejuno-jejunostomy <ol><li> Mikro makas kullanarak proksimal ekstremite ve bağırsak döngü hem kesmek için ve aynı uzunlukta iki antimezenterik insizyon (Şekil 2G ve 2H) gerçekleştirin. </li><li> İki 8.0 ile yan-yan anastomoz gerçekleştirinolmayan emilebilir dikişlerle. Ventral yüzü anastomoz (Şekil 2J) takip sırt tarafında anastomoz ilk (Şekil 2I), gerçekleştirin. </li><li> Yavaşça dikiş sızdırmaz olmasını sağlamak için anastomoz her tarafına doğru 2 nemli bir pamukla yuvarlayın. sızıntı durumunda 8.0 olmayan emilebilir dikişlerle tamamlayın. </li></ol></li><li> Gastro-jejunostomi <ol><li> Yavaşça nemli bir pamukla kullanarak mide seferber. nemli bir pamukla veya mikro makas kullanarak yanal yakın bağ dokusu ekleri mide ücretsiz. </li><li> Yavaşça, yeniden emilebilir hemostatik kollajen mide arkasında sıkıştırmak yerleştirerek, tam mide dışa. Kavisli mikro forseps (Şekil 2K ve 2L) ile omentum geçirilen 5,0 emilemeyen sütür kullanarak pilor bir bitişik harfleri gerçekleştirin. </li><li> ventral mide tarafı, pilor 1,5 cm, ve distal ekstremite hem Cutaynı uzunlukta (Şekil 2M) iki kesiler yaratarak, mikro makas kullanılarak. </li><li> İki 8.0 olmayan emilebilir dikişlerle yan-yan anastomoz gerçekleştirin. Dorsal yan anastomoz (Şekil 2N) ile başlayın ve daha sonra ventral yüzü anastomoz (Şekil 2O) gerçekleştirin. Yavaşça dikiş sızdırmaz olmasını sağlamak için anastomoz her tarafına doğru 2 nemlendirilmiş pamuklu çubuklarla yuvarlayın. sızıntı durumunda 8.0 olmayan emilebilir dikişlerle tamamlayın. </li></ol></li><li> karın kapatma <ol><li> 5.0 olmayan emilebilir sütürler (Şekil 2P) kullanılarak karın duvarı kas tabakası kapatın. % 1 izofluran konsantrasyonu azaltarak anestezi azaltın. Deri altına enjeksiyon yolu ile, ılık tuzlu su çözeltisi 25 ml / kg .Administer 5.0 emilmeyen dikişlerle (Şekil 2Q) ile cilt kapatın. </li></ol></li></ol> 4. Genel Ameliyat Sonrası Bakım <ol><li> izofluran durdurFare tamamen uyanık olduğu kadar ve 0.8 L / dk O 2 akışı ile devam ediyor. kafesin etrafında taşımak ve durmak ve düşmeden yürümek mümkün hayvan başlayan gösterilen motor kontrolü, kavuşur kadar sahipsiz fare bırakmayın. </li><li> 5 gün için 30 ° C sıcaklık koşullarında bir inkübatör içinde fare (kafes başına sadece bir fare) yerleştirin. </li><li> protokol sonuna kadar RYGB farelerde ve vitaminler (800 mg / 180 ml su içinde) ilaveleri, demir (deri altına enjeksiyon, 0.5 mg / kg / gün) tutun. </li><li> Ameliyattan sonra 5 gün: (% 10 domuz yağı,% 10 sıvı şeker,% 57 su, yüksek yağlı jel diyet) ücretsiz jel diyet yiyecek erişimi dönün. 3 gün ameliyattan sonra katı bir diyet reintroduce. </li><li> Deri altına, meloksikam (ameliyat sonrası gün ila 3 gün 0, günde iki kez 0.1 mg / kg) (1 mg / kg, 0. günden ameliyat sonrası gün ila 3), metoklopramid (1 mg / kg, günde 0 ila buprenorfin enjekte ameliyat sonrası gün 5) ve marbofloxacine (10 mg / kg, gün 0 ila gün 3 Aften<html> r cerrahisi). </li></ol> 5. Postoperatif Metabolik Parametreler Değerlendirme <ol><li> Gıda alımı ölçümü <ol><li> Fareler ameliyattan sonra 1 hafta kurtarmak için izin verin. Ev farenin kafes başına on. kafes yerleştirilir katı diyet miktarını ölçün. Ağırlık kalan gıda 24 saat sonra. sürece gerektiği gibi bu adımı yineleyin. </li></ol></li><li> Oral glukoz tolerans testi <ol><li> Oral bolus önce 6 saat boyunca fareler hızlı. kuyruk ucundan bir kan damlası hasat ve zaman 0 kan şekeri değerini belirlemek için bir glucometer takılı bir glikoz şeridi üzerinde uygulayın. </li><li> % 20 D-glikoz çözeltisi (2 g / kg) bir oral ölçülü yönetme. 15 yaşında 30, 60, ve 120 dakika sonrası sonda, kan şekeri düzeylerini ölçmek. </li></ol></li><li> Hemoglobin düzeyi analizi <ol><li> Bir hematoloji sistemi kullanarak, hemoglobin düzeyi örnek taze kan 20 uL ölçmek. </li></ol></li></ol>&quot;&gt; 6. Ötenazi <ol><li> intraperitoneal olarak ksilazin / ketamin çözeltisi (10/80 mg / kg) enjekte edilerek fareler anestezi. servikal dislokasyon gerçekleştirin. Kalp atmıyor ve göz küresi göz kırpma refleksi kaybolur sağlayarak tam ötenazi doğrulayın. </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.

artan obezite salgını üstesinden gelmek için, ilk bariatrik cerrahi prosedürleri ABD&#39;de 1960&#39;larda ortaya çıktı. O zamandan beri, prosedürlerin sayısı hala her yıl dünya çapında gerçekleştirilen artırmak ve bugün, bu teknikler morbid obezite 6 yönetimi için en iyi tedavi seçeneği oluşturmaktadır. Geliştirilen prosedürler arasında, SG ve RYGB klinik pratikte 4&#39;te kullanılan en popüler iki yöntem vardır. Hayvan modelleri, özellikl...

obezite ve diyabet dünya çapında salgın şiddetinde yıkıcı. Dünya çapında iki milyar yetişkin (nüfusun% 30) fazla kilolu (BKİ&gt; 25 kg / m2) ve obez (BKİ&gt; 30 kg / m2) ya 1. Bu artmış morbidite ve mortalite lider, tip 2 diyabet, hipertansiyon ve dislipidemi gibi metabolik komplikasyonlar ile birlikte gelebilir. Obezite genel mortalite ve kanser 2 sıklığını arttırır. Nedeniyle etkili bir non-invaziv tedavilerin eksikliği, obezite cerrahisi uzun vadeli, sürekli kilo kaybı 3, 4 yol açabilir tek seçenek temsil eder. Farklı cerrahi yöntemler bir dizi geliştirilmiştir, ancak sleeve gastrektomi (SG) ve Roux-en-Y gastrik bypass (RYGB) klinik pratikte en yaygın olarak kullanılan iki yöntem vardır. SG prosedürü sırasında mide başlangıç ​​hacminin 80% olduğuçıkarıldı; böylece, bu teknik tokluk artırır kısıtlayıcı ameliyatlar biridir. RYGB kısıtlayıcı-malabzorptif tekniklerden biridir. RYGB sırasında, küçük bir mide kese (toplam mide hacminin% 1-2) oluşturulur ve bağırsak sindirim ve besinlerin emilmesini geciktirir Y-şekil, içine yeniden düzenlenmektedir. Bu iki teknik RYGB görülen daha yüksek bir verimlilik ile, sık ilişkili eşlik eden önemli vücut ağırlığı azalma ve genel gelişmeler (örneğin, hipertansiyon, tip 2 diyabet ve dislipidemi) 3 yol açar. Ancak, obezite ameliyatları pleiotropik yararlı etkileri arkasında moleküler mekanizmaları genellikle tam olarak açıklığa kavuşturulamamıştır. Bağlı bulunan çok sayıda genetik olarak modifiye edilmiş suşlar, bir fare modeli, bu moleküler mekanizmaları keşfetmek için en uygun hayvan modelidir. Ancak, obezite prosedürler küçük hayvan modellerinde ve requir doğrudan adapte etmek zorduryüksek cerrahi maharet e. SG kolayca ve çok iyi bir hayatta kalma oranı ile kemirgenlerde gerçekleştirilebilir olsa da, RYGB şiddetli barsak engel 5 farelerde ölümcüldür. Farklı modifiye RYGB teknikleri, bu sorun, özellikle oesojejunostomy 5 karşı koymak için önerilmiştir. Bir mide eksizyon olmadan gastrojejunostomi: Burada başka bir alternatif sunuyoruz. Bu modifiye RYGB üretir insanlarda gözlenen yararlı etkileri çoğu (yani, vücut ağırlığında anlamlı bir azalma ve glukoz ve lipid homeostazında bir gelişme). Bu yazıda özetlemek ve farelerde SG ve RYGB teknik ve deneysel ayrıntılarını görüşmek ve videolar yardımıyla bu prosedürlerini kolaylaştırmak için hedefliyor. Belirli bir vurgulamak vitamini ve demir eksikliklerinin azaltılmasına olanak sağlar preoperatif ve postoperatif sağlık protokolleri optimizasyonu ile ilgili yapılacaktır.

<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

Obezite (2003 yılından 2008 yılına kadar) Avrupa&#39;da 4 kadın,% 36.5 erkekler için% 28 ve 6.2 prevalansı, önemli bir halk sağlığı sorunudur. Morbid obezite sık yaşam süresi ve kalite azaltma, tip 2 diyabet, hipertansiyon ve dislipidemi gibi metabolik komplikasyonların ile ilişkilidir. Etkili bir non-invaziv tedavilerin yokluğunda, bariatrik cerrahi morbid obezite hastalarında (vücut kitle indeksi (BMI)&gt; 40 kg / m2) için değerli bir tedavi seçeneği uzun vadeli lider olduğunu, metabolik komplikasyonlar kilo kaybı ve iyileştirmeler sürekli . Ancak, obezite cerrahisinin yararlı etkileri sürdürülmesi altta yatan hücresel ve moleküler mekanizmalar henüz tam olarak anlaşılamamıştır. Nedeniyle sayısız genetiği değiştirilmiş suşlar, fare modeli obezite ameliyatları pleiotropik yararlı etkileri arkasında moleküler mekanizmaları keşfetmek için en uygun hayvan modelidir. Burada, optimize edilmiş healthc ayrıntılısleeve gastrektomi ve modifiye Roux-en-Y gastrik bypass: iki en yaygın kullanılan bariatrik ameliyatlar için farelerde yöntemleri ve cerrahi protokoller vardır. Obezite cerrahisinde tedavi etkilerinin altında yatan moleküler mekanizmaları Deşifre yeni terapötik hedefler belirlenmesi söz sunmaktadır.

Genel Şartlar SG işlemi için ortalama ameliyat süresi 49.3 ± 1.5 dakika idi. Bu mide yaklaşık% 80 oranında temsil mide 62.8 ± 5.0 mg, kaldırıldı. Hiçbir fareler ameliyat sırasında ya da aşağıdaki yedi gün içinde öldü. Bir fare (% 7.1), çünkü bir bezoar neden olduğu mide tıkanıklığı 11. günde kaybedildi. RYG...

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.

Sleeve gastrektomi Teknikleri ve Farelerde Roux-en-Y Gastrik Bypass Modifiye

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 ...

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11.9K Görüntüleme.  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.

Fare Koroner Arter Ligasyonu için Modifiye Tekniği

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 ...

Tıp

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.

Sıçanlarda Roux-en-Y Gastrik Bypass Operasyonu

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.

Bir Kullanarak Non-obez Diyabetik Farelerde Mide boşaltılması Değerlendirilmesi [<sup&gt; 13</sup&gt; C]-oktanoik asit Nefes Testi

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.

Kol tekniği aort transplantasyonu - eğitici bir Video bir fare Model kullanma

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.

Cerrahi Klipsler Kullanılarak Farelerde Sleeve Gastrektomi

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.

Doğrusal Zımbalar Kullanan Sıçanlarda Roux-en-Y Gastrik Bypass protokolü

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.

Farelerde Sleeve Gastrektomi Modeli ile Tek Anastomoz Duodeno-İleal Bypass

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.

Dikey kol gastrektomi fare modeli

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

Biyoloji

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

Source: Ayer, A., et al., <a href="https://www.jove.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.

Roux-en-Y Gastrik Bypass Prosedürü: Murin Modelinde Gastrik Rezeksiyon için Bariatrik Cerrahi Prosedür

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 ...

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Kemirgen Modelleri

Yetişkin

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.

Sleeve gastrektomi Teknikleri ve Farelerde Roux-en-Y Gastrik Bypass Modifiye

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