One-anastomosis Gastric Bypass (OAGB) in Rats

Matthieu A. Siebert; Jean-Marc Chevallier; Diego D'Aurelle de Paladines; Yohann Pottier; Simon Msika; Maude Le Gall; André Bado; Lara Ribeiro-Parenti

doi:10.3791/58776

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Method Article

One-anastomosis Gastric Bypass (OAGB) in Rats

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DOI:

10.3791/58776

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November 10th, 2018

Matthieu A. Siebert¹ , Jean-Marc Chevallier² , Diego D'Aurelle de Paladines¹ , Yohann Pottier¹ , Simon Msika¹^,³ , Maude Le Gall¹ , André Bado¹ , Lara Ribeiro-Parenti¹^,³

¹Institut national de la santé et de la recherche médicale (Inserm) unité mixte de recherche (UMR) 1149, Unité de formation et de recherche (UFR) de Médecine Paris Diderot, Universit é Paris Diderot, Assistance Publique-Hôpitaux de Paris (AP-HP), ²Department of digestive Surgery, AP-HP Hôpital Européen Georges Pompidou, ³Department of General and Visceral Surgery, Bichat-Claude Bernard University Hospital

Summary

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.

Abstract

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.

Introduction

Morbid obesity is a major health issue in the western world, with increasing prevalence¹. Bariatric surgery remains the only long-term effective therapy for morbid obesity², with clear benefits on obesity-related comorbidities³. Roux-en-Y gastric bypass (RYGB) remains the gold standard as it is one of the oldest procedures and one of the most-performed worldwide with the longest follow-up⁴. OAGB is a more recent procedure first described in 2001 by Rutledge⁵. It has been described as an effective alternative to RYGB⁶ and has s....