Name: roux-en-y gastric bypass operation in rats
Uploaded: 2012-06-11T13:00:00
Description: Watch this Scientific Journal Video about Roux-en-Y Gastric Bypass Operation in Rats at JoVE.com

Marco Bueter och Florian Seyfried fick stöd av Deutsche Forschungsgemeinschaft (DFG). Thomas A Lutz stöddes av den schweiziska National Research Foundation (SNF). Marco Bueter och Thomas A Lutz dessutom få stöd från National Institute of Health (NIH) och från Zürich Centrum för integrativ Human Physiology (ZIHP). Carel W le Roux fick stöd av en Department of Health Clinician forskare utmärkelse. Imperial College London får stöd från NIHR Biomedical Research Centre finansiering.

1. Preoperativ Care <ol><li> Ta bort mat från råtta natten före operation. </li><li> Inducera anestesi hos kammaren med 4-5% isofluran och O2 flöde av 2 liter / min. </li><li> Raka buken från bröstbenet till bäcken med rakapparat. </li><li> Placera sövd råtta i liggande läge på isotermisk värmedyna. </li><li> Applicera ögonsalva (Vitagel) innan du placerar råttornas nos i noskonen. </li><li> Upprätthålla anestesi med isofluran koncentration på 2-3% och O2 flöde av 2 l / min. </li><li> Desinficera hud...

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	<li>Adams, T. D., Gress, R. E., Smith, S. C. <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+mortality+after+gastric+bypass+surgery.">Long-term mortality after gastric bypass surgery.</a> N. Engl. J. Med. 357, 753-761 (2007).</li><li>Sjostrom, L., Lindroos, A. K., Peltonen, M. <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> N. Engl. J. Med. 351, 2683-2693 (2004).</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.">Metabolic/bariatric surgery Worldwide.</a> Obes. Surg. 19, 1605-1611 (2008).</li><li>Welbourn, R., Werling, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gut+hormones+as+mediators+of+appetite+and+weight+loss+after+Roux-en-Y+gastric+bypass.">Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass.</a> Ann. Surg. 246, 780-785 (2007).</li><li>le Roux, C. W., Aylwin, S. J., Batterham, R. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gut+hormone+profiles+following+bariatric+surgery+favor+an+anorectic+state,+facilitate+weight+loss,+and+improve+metabolic+parameters.">Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters.</a> Ann. Surg. 243, 108-114 (2006).</li><li>Bueter, M., Lowenstein, C., Olbers, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gastric+bypass+increases+energy+expenditure+in+rats.">Gastric bypass increases energy expenditure in rats.</a> Gastroenterology. 138, 1845-1853 (2010).</li><li>Stylopoulos, N., Hoppin, A. G., Kaplan, L. M. <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+Enhances+Energy+Expenditure+and+Extends+Lifespan+in+Diet-induced+Obese+Rats.">Roux-en-Y Gastric Bypass Enhances Energy Expenditure and Extends Lifespan in Diet-induced Obese Rats.</a> Obesity (Silver Spring). 17, 1839-1847 (2009).</li><li>Bueter, M., Miras, A. D., Chichger, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alterations+of+sucrose+preference+after+Roux-en-Y+gastric+bypass.">Alterations of sucrose preference after Roux-en-Y gastric bypass.</a> Physiol. Behav. 104, 709-721 (2011).</li><li>le Roux, C. W., Bueter, M., Theis, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gastric+bypass+reduces+fat+intake+and+preference.">Gastric bypass reduces fat intake and preference.</a> Am. J. Physiol. Regul. Integr. Comp. Physiol. 301, 1057-1066 (2011).</li><li>Bueter, M., Ashrafian, H., Frankel, A. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sodium+and+water+handling+after+gastric+bypass+surgery+in+a+rat+model.">Sodium and water handling after gastric bypass surgery in a rat model.</a> Surg. Obes. Relat. Dis. 7, 68-73 (2011).</li><li>Li, J. V., Ashrafian, H., Bueter, 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+surgery+profoundly+influences+gut+microbial-host+metabolic+cross-talk.">Metabolic surgery profoundly influences gut microbial-host metabolic cross-talk.</a> Gut. 60, 1214-1223 (2011).</li><li>Ashrafian, H., le Roux, 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=Metabolic+surgery+and+gut+hormones+-+a+review+of+bariatric+entero-humoral+modulation.">Metabolic surgery and gut hormones - a review of bariatric entero-humoral modulation.</a> Physiol. Behav. 97, 620-631 (2009).</li><li>Ashrafian, H., Bueter, M., Ahmed, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Metabolic+surgery:+an+evolution+through+bariatric+animal+models.">Metabolic surgery: an evolution through bariatric animal models.</a> Obes. Rev. 11, 907-920 (2010).</li><li>Rao, R. 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J. 76, 1217-1221 (1983).</li><li>Guijarro, A., Suzuki, S., Chen, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+weight+loss+and+weight+regain+mechanisms+after+Roux-en-Y+gastric+bypass+in+rats.">Characterization of weight loss and weight regain mechanisms after Roux-en-Y gastric bypass in rats.</a> Am. J. Physiol. Regul. Integr. Comp. Physiol. 293, R1474-R1489 (2007).</li><li>Roberts, K., Duffy, A., Kaufman, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Size+matters:+gastric+pouch+size+correlates+with+weight+loss+after+laparoscopic+Roux-en-Y+gastric+bypass.">Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass.</a> Surg. 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K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Decrease+in+sweet+taste+in+rats+after+gastric+bypass+surgery.">Decrease in sweet taste in rats after gastric bypass surgery.</a> Surg. Endosc. 25, 1176-1181 (2011).</li><li>Olbers, T., Lonroth, H., Fagevik-Olsen, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoscopic+gastric+bypass:+development+of+technique,+respiratory+function,+and+long-term+outcome.">Laparoscopic gastric bypass: development of technique, respiratory function, and long-term outcome.</a> Obes. Surg. 13, 364-370 (2003).</li><li>Madan, A. K., Harper, J. L., Tichansky, D. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Techniques+of+laparoscopic+gastric+bypass:+on-line+survey+of+American+Society+for+Bariatric+Surgery+practicing+surgeons.">Techniques of laparoscopic gastric bypass: on-line survey of American Society for Bariatric Surgery practicing surgeons.</a> Surg. Obes. Relat. Dis. 4, 166-172 (2008).</li><li>Bueter, M., Lowenstein, C., Ashrafian, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Vagal+sparing+surgical+technique+but+not+stoma+size+affects+body+weight+loss+in+rodent+model+of+gastric+bypass.">Vagal sparing surgical technique but not stoma size affects body weight loss in rodent model of gastric bypass.</a> Obes. Surg. 20, 616-622 (2010).</li><li>Korner, J., Bessler, M., Cirilo, L. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+Roux-en-Y+gastric+bypass+surgery+on+fasting+and+postprandial+concentrations+of+plasma+ghrelin,+peptide+YY,+and+insulin.">Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY, and insulin.</a> J. Clin. Endocrinol. Metab. 90, 359-365 (2005).</li><li>Schwartz, M. W., Woods, S. C., Porte, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Central+nervous+system+control+of+food+intake.">Central nervous system control of food intake.</a> Nature. 404, 661-671 (2000).</li><li>Abbott, C. R., Monteiro, M., Small, C. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+inhibitory+effects+of+peripheral+administration+of+peptide+YY(3-36)+and+glucagon-like+peptide-1+on+food+intake+are+attenuated+by+ablation+of+the+vagal-brainstem-hypothalamic+pathway.">The inhibitory effects of peripheral administration of peptide YY(3-36) and glucagon-like peptide-1 on food intake are attenuated by ablation of the vagal-brainstem-hypothalamic pathway.</a> Brain Res. 1044, 127-131 (2005).</li><li>Adrian, T. E., Ballantyne, G. H., Longo, W. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Deoxycholate+is+an+important+releaser+of+peptide+YY+and+enteroglucagon+from+the+human+colon.">Deoxycholate is an important releaser of peptide YY and enteroglucagon from the human colon.</a> Gut. 34, 1219-1224 (1993).</li><li>Nakatani, H., Kasama, K., Oshiro, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Serum+bile+acid+along+with+plasma+incretins+and+serum+high-molecular+weight+adiponectin+levels+are+increased+after+bariatric+surgery.">Serum bile acid along with plasma incretins and serum high-molecular weight adiponectin levels are increased after bariatric surgery.</a> Metabolism. 58, 1400-1407 (2009).</li><li>Ashrafian, H., le Roux, 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=Metabolic+surgery+and+gut+hormones+-+a+review+of+bariatric+entero-humoral+modulation.">Metabolic surgery and gut hormones - a review of bariatric entero-humoral modulation.</a> Physiol. Behav. 97, 620-631 (2009).</li><li>Choban, P. S., Flancbaum, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+Roux+limb+lengths+on+outcome+after+Roux-en-Y+gastric+bypass:+a+prospective,+randomized+clinical+trial.+Obes.">The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes.</a> Surg. 12, 540-545 (2002).</li><li>Gleysteen, J. 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Den Roux-en-Y gastric bypass förfarande människa beskrevs först av Mason 1967 och ändrade till sin nuvarande form av Torres 1983 19. För närvarande består förfarandet av en liten mag-påse och förbiledningen av den proximala tunntarmen. En schematisk illustration av pre-och postoperativt anatomi ges i figur 1. Bypass i människor inducerar och bibehåller förlust kroppsvikt av ca 15-30% 2. Majoriteten av kroppsvikten försvinner under de förs...

<table border="1"><tbody><tr><td> Samlingsnamn </td><td> Varumärke </td><td> Företaget </td><td> Katalognummer </td></tr><tr><td> Enrofloxacin </td><td> Baytril 2,5% </td><td> Provet AG </td><td> 1036 </td></tr><tr><td> Flunixin </td><td> Finadyne </td><td> Graeub </td><td> 908.040 </td></tr><tr><td> Buprenorfin </td><td> Temgesic </td><td> Reckitt Benckiser </td><td> 138.976 </td></tr><tr><td> Isofluran </td><td> ISOFLO </td><td> Graeub </td><td> 902.035 </td></tr><tr><td> Vitamin A </td><td> Vitagel </td><td> Bausch &amp; Lomb </td><td> 690 </td></tr><tr><td> Jodlösning </td><td> Betadin </td><td> Mundipharma </td><td> 111.141 </td></tr><tr><td> NaCl 0,9% </td><td> NaCl 0,9% </td><td> B. Braun </td><td> 534.534 </td></tr></tbody></table> Tabell 1. Narkotika. <table border="1"><tbody><tr><td> Namn </td><td> Storlek </td><td> Företaget </td><td> Katalognummer </td></tr><tr><td> PDS II </td><td> 4-0 </td><td> Ethicon </td><td> Z924H </td></tr><tr><td> PDS II </td><td> 5-0 </td><td> Ethicon </td><td> Z925H </td></tr><tr><td> PDS II </td><td> 6-0 </td><td> Ethicon </td><td> PUU2971E </td></tr><tr><td> PDS II </td><td> 7-0 </td><td> Ethicon </td><td> Z1370E </td></tr><tr><td> Vicryl </td><td> 4-0 </td><td> Ethicon </td><td> V451H </td></tr></tbody></table> Tabell 2. Suturer. <table border="1"><tbody><tr><td> Namn </td><td> Företaget </td><td> Katalognummer </td></tr><tr><td> Skalpellhandtaget Nr 3 </td><td> Aesculap </td><td> BB073R </td></tr><tr><td> Skalpellblad Inga. 10 </td><td> Swann Morton- </td><td> 0301 </td></tr><tr><td> Nålhållaren </td><td> Aesculap </td><td> BM124R </td></tr><tr><td> Vävnad pincett </td><td> Aesculap </td><td> BD555R </td></tr><tr><td> Metzenbaum sax, rak </td><td> Aesculap </td><td> BC022R </td></tr><tr><td> Metzenbaum sax, böjd </td><td> Aesculap </td><td> BC023R </td></tr><tr><td> Ömtåliga sax, svängda </td><td> Aesculap </td><td> BC061R </td></tr><tr><td> Artär pincett, krökt </td><td> Aesculap </td><td> BH109R </td></tr><tr><td> Artär pincett, böjda, 1x2 tänder </td><td> Aesculap </td><td> BH121R </td></tr><tr><td> Probe, dubbeländad </td><td> Aesculap </td><td> BN113R </td></tr><tr><td> Mikro nålhållaren </td><td> Aesculap </td><td> FM-541R </td></tr><tr><td> Mikro pincett </td><td> Aesculap </td><td> FM571R </td></tr><tr><td> Mikro sax </td><td> AESCulap </td><td> FM470R </td></tr><tr><td> Engångstyp ögat kauterisation </td><td> John Weiss International </td><td> 0111122 </td></tr><tr><td> Bomullspinnar </td><td> Hartmann AG </td><td> 9679369 </td></tr></tbody></table> Tabell 3. Kirurgisk utrustning.

roux-en-y gastric bypass operation in rats

För närvarande är den mest effektiva för behandling av sjuklig fetma att inducera betydande och underhålls förlust kroppsvikt, med en beprövad mortalitet förmån obesitaskirurgi 1,2. Följaktligen har det skett en stadig ökning av antalet bariatric verksamhet gjort över hela världen under de senaste åren med Roux-en-Y gastric bypass (gastric bypass) är den vanligaste typen av trafik 3. Mot denna bakgrund är det viktigt att förstå de fysiologiska mekanismer som gastric bypass inducerar och upprätthåller förlust kroppsvikt. Dessa mekanismer är ännu inte helt klarlagda, men kan innefatta minskad hunger och ökad mättnadskänsla 4,5, ökad energiförbrukning 6,7, förändrad preferens för livsmedel med hög fett och socker 8,9 ändrade salt och vatten hantering av njuren 10 som samt förändringar i tarmfloran 11. Sådana förändringar ses efter gastric bypass kan åtminstone delvis härrör från huroperationen förändrar hormonella miljön eftersom gastric bypass ökar postprandiala frisättningen av peptid-YY (PYY) och glukagon-like-peptid-1 (GLP-1), hormoner som frigörs genom tarmen i närvaro av näringsämnen och som minskar äta 12. Under de senaste två decennierna flera studier med råttor har genomförts för att ytterligare undersöka fysiologiska förändringar efter gastric bypass. Den gastric bypass råttmodell har visat sig vara ett värdefullt experimentell verktyg inte minst när det noga imiterar tidsprofil och omfattningen av mänskliga viktminskning, men också tillåter forskare att kontrollera och manipulera kritiska anatomiska och fysiologiska faktorer, inklusive användning av lämpliga kontroller. Följaktligen finns det ett brett spektrum av bypass råtta mag modeller i litteraturen omdömet håll i närmare 13-15. Beskrivningen av den exakta kirurgiska tekniken av dessa modeller varierar kraftigt och skiljer sig t.ex. i form av påse storlek, hälsalängder, och bevarande av vagusnerven. Om rapporterats, dödlighet verkar variera från 0 till 35% 15. Dessutom har operation utförts nästan uteslutande i hanråttor av olika stammar och åldrar. Pre-och postoperativ kost varierade också betydligt. Tekniska och experimentell variationer i publicerade råtta gastric bypass modellerna försvårar jämförelsen och identifiering av potentiella fysiologiska mekanismer som är involverade i gastric bypass. Det finns inga tydliga bevis för att någon av dessa modeller är överlägsen, men det finns ett växande behov av standardisering av förfarandet för att uppnå konsekventa och jämförbara uppgifter. Denna artikel syftar därför till att sammanfatta och diskutera tekniska och experimentella information om vårt tidigare validerat och publiceras gastric bypass råttmodell.

Watch this Scientific Journal Video about Roux-en-Y Gastric Bypass Operation in Rats at JoVE.com

Roux-en-Y Gastric Bypass Operation in Rats

Ett flertal studier med gastric bypass modeller råtta har nyligen genomförts för att avslöja de bakomliggande fysiologiska mekanismer Roux-en-Y gastric bypass-operationer. Denna artikel syftar till att visa och diskutera de tekniska och experimentella detaljer vår publicerade gastric bypass råttmodell att förstå fördelar och begränsningar i denna experimentella verktyg.

Roux-en-Y gastric bypass operation i råttor

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