Name: Manufacturing Devices and Instruments for Easier Rat Liver Transplantation (Video) | JoVE Journal
Uploaded: 2013-05-05T14:00:00.000+00:00
Duration: 8 min 2 s
Description: Learn to manufacture the quick-linker device for orthotopic rat liver transplantation using common laboratory materials. This accessible kit improves surgical efficiency and enables unlimited reuse for researchers.

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5 minutes

The study was supported by the Art&egrave;res Foundation, the Astellas Foundation Europe and the Boninchi Foundation. CT was supported by the Swiss National Science Foundation (SCORE grant 3232230-126233).

1. Handle: Design and Shaping
<ol>
 <li>Secure an Nr 10 carbon scalpel blade on a wooden board with a tape.</li>
 <li>Tag the center of the ring under the microscope. It should be located 1.2 cm straight from the grove of the scalpel blade.</li>
 <li>Drill a 2 mm hole with a spherical diamond bit, mounted on a high-speed drill.</li>
 <li>Widen the hole with fusiform or conic diamond bits. The final diameter varies according to the rat weight as shown in Table 1.</li>
 <li>Design the shape of the handle with a permanent marker. Figures 1 and 2 can be used as stencils.</li>
 <li>Convert the drill into a mini bench grinder and remove the part of the blade outside the shape.</li>
 <li>Round off the piece with a low speed rotating brush.</li>
</ol>
2. Approximator: Design and Shaping
<ol>
 <li>The approximator is obtained by modifying straight surgical Klemmer's or Kocher's forceps.</li>
 <li>Cut off half of one branch under the microscope using the high-speed mini bench grinder.</li>
 <li>Make symmetrical grooves on both sides to allow for the handle to slide in completely. </li>
 <li>Cut a longitudinal slit in the long arm and check that the center of the long arm and a well-positioned handle are on a same axis. </li>
 <li>Design a notch on the long arm facing the center of the handle. </li>
 <li>Make the branch as thin as possible and round off the piece with the low speed rotating brush. </li>
</ol>
3. Cuffs: Design and Shaping
<ol>
 <li>Cuff calipers vary according to the rat weight and strain. By contrast, their length should be kept around 4 mm. </li>
 <li>Take fine-bore polyethylene tubing and round off one edge with an Nr 10 scalpel. </li>
 <li>Design a grove 0.5 mm from the edge, and carefully cut out a slope going down to the grove. </li>
 <li>Cut out one or two full-thickness nicks into the tubing. These will help manipulating the cuff during graft preparation and transplantation.</li>
 <li>Cut the cuff at 4 mm from its edge. </li>
</ol>

<ol><li>Oldani, G., Lacotte, S., Morel, P., Mentha, G., Toso, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Orthotopic+Liver+Transplantation+in+Rats%5BTitle%5D)+AND+%22J.+Vis.+Exp%22%5BJournal%5D)">Orthotopic Liver Transplantation in Rats.</a> J. Vis. Exp. (65), e4143(2012).</li>
<li>Hori, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Comprehensive+and+innovative+techniques+for+liver+transplantation+in+rats%3A+A+surgical+guide%5BTitle%5D)+AND+%22World+Journal+of+Gastroenterology.%2C+WJG%22%5BJournal%5D)">Comprehensive and innovative techniques for liver transplantation in rats: A surgical guide.</a> World Journal of Gastroenterology., WJG. 16, 3120(2010).</li>
<li>Kashfi, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+review+of+various+techniques+of+orthotopic+liver+transplantation+in+the+rat%5BTitle%5D)+AND+%22Transplantation+Proceedings%22%5BJournal%5D)">A review of various techniques of orthotopic liver transplantation in the rat.</a> Transplantation Proceedings. 37 (1), 185-188 (2005).</li>
<li>Kamada, N., Calne, R. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Orthotopic+liver+transplantation+in+the+rat.+Technique+using+cuff+for+portal+vein+anastomosis+and+biliary+drainage%5BTitle%5D)+AND+%22Transplantation%22%5BJournal%5D)">Orthotopic liver transplantation in the rat. Technique using cuff for portal vein anastomosis and biliary drainage.</a> Transplantation. 28, 47(1979).</li>
<li>Oldani, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+novel+technique+for+rat+liver+transplantation+using+Quick+Linker+system%3A+a+preliminary+result%5BTitle%5D)+AND+%22Journal+of+Surgical+Research%22%5BJournal%5D)">A novel technique for rat liver transplantation using Quick Linker system: a preliminary result.</a> Journal of Surgical Research. 149, 303-309 (2008).</li>
</ol>

The authors have nothing to disclose.

The present report describes the design and building of the quick-linker system for easier rat liver transplantation.
Rat liver transplantation is a popular model with 125 to 180 related papers published yearly since the early 1990's (<a href="http://www.pubmed.com" target="_blank">www.pubmed.com</a>). It allows for a wide range of experiments including the exploration of immunological and graft preservation issues. The use of the "quick-linker" kit allows for easier and quicker anastomoses with guaranteed intima-to-intima contact. A detailed description and discussion of the technical steps of a rat liver transplantation have been described previously 1. 
The quick-linker kit can be built at low price from common laboratory material. The main challenge encountered has been related the breakdown of one handle during the final brushing, and that problem has been solved by setting the narrowest part of the handle ring at 0.5 mm (Figures 1 and 2 show appropriate sizes). Regarding the blade quality, only stainless steel should be considered. Although slightly less flexible compared to the average carbon steel blade, stainless steel blades do not develop rust, allowing a lifetime use of the handles. 
Of note, the design of the current handles and cuffs is the result of a process, which has led to the proposed sizes, allowing for the most efficient anastomoses. Cuff diameters vary according to the rat weights (Table 1). Minimal variations can be tolerated in terms of length, with a usual length of about 4 mm (Figures 3 and 4). 
Regarding the approximator, the selected Kocher's forcep should have handles at least 4 cm from the fulcrum. This allows for a safe closure of the rack outside the animal's abdomen. 
Overall, the proposed device can allow easier vein anastomoses for the transplantation of liver and other types of grafts in rats.

A technique of orthotopic rat liver transplantation has been shown in a recent Journal of Visualized Experiments paper 1. Portal vein and infra-hepatic vena cava anastomoses were performed using the quick-linker assisted cuff technique. This technique was chosen among other revisions of the original Kamada's technique 2-4, as it allows for easier and quicker anastomoses, results in a better hemodynamic, and can be implemented with a shorter learning curve 1,5.
The quick-linker technique requires the use of a handle, an approximator and cuffs, all of which can be designed from common laboratory material according to the technique described in the present report.

<table><tbody><tr><td>Porta cuff</td><td>altecweb or smiths-medical</td><td>Coil 01-96-1729&lt;br/&gt; 800/100/420</td><td>Bore : variable &lt;br/&gt; Wall : 0.30 mm &lt;br/&gt; Length: 3.8-4.2 mm&lt;br/&gt; &lt;a href=&quot;http://altecweb.com&quot; target=&quot;_blank&quot;&gt;altecweb.com&lt;/a&gt; or &lt;a href=&quot;http://smiths-medical.com&quot; target=&quot;_blank&quot;&gt;smiths-medical.com&lt;/a&gt;</td></tr><tr><td>IVC cuff</td><td>altecweb or smiths-medical</td><td>Coil 01-96-1733&lt;br/&gt; 800/100/540</td><td>Bore : variable &lt;br/&gt; Wall : 0.30 mm&lt;br/&gt; Length: 3.8-4.2 mm&lt;br/&gt; &lt;a href=&quot;http://altecweb.com&quot; target=&quot;_blank&quot;&gt;altecweb.com&lt;/a&gt; or &lt;a href=&quot;http://smiths-medical.com&quot; target=&quot;_blank&quot;&gt;smiths-medical.com&lt;/a&gt;</td></tr><tr><td>Mini-drill </td><td>Dremel</td><td>100 series</td><td>35,000 rpm&lt;br/&gt; &lt;a href=&quot;http://dremel.com&quot; target=&quot;_blank&quot;&gt;dremel.com&lt;/a&gt;</td></tr><tr><td>Diamond wheel point</td><td>Dremel</td><td>7103</td><td>2 mm&lt;br/&gt; &lt;a href=&quot;http://dremel.com&quot; target=&quot;_blank&quot;&gt;dremel.com&lt;/a&gt;</td></tr><tr><td>Diamond wheel point</td><td>Dremel</td><td>7105</td><td>4.4 mm&lt;br/&gt; &lt;a href=&quot;http://dremel.com&quot; target=&quot;_blank&quot;&gt;dremel.com&lt;/a&gt;</td></tr><tr><td>Diamond wheel point</td><td>Dremel</td><td>7144</td><td>2.4 mm&lt;br/&gt; &lt;a href=&quot;http://dremel.com&quot; target=&quot;_blank&quot;&gt;dremel.com&lt;/a&gt;</td></tr><tr><td>Cut-off wheels</td><td>Dremel</td><td>420</td><td>dia: 23.8 mm&lt;br/&gt; thickness: 0.5 mm&lt;br/&gt; &lt;a href=&quot;http://dremel.com&quot; target=&quot;_blank&quot;&gt;dremel.com&lt;/a&gt;</td></tr><tr><td>Quick-linker handles</td><td>dltchiropody (DLT)</td><td>PAR 10</td><td>modified scalpel blades&lt;br/&gt; &lt;a href=&quot;http://dltchiropody.co.uk&quot; target=&quot;_blank&quot;&gt;dltchriopdy&lt;/a&gt;</td></tr><tr><td>Quick-linker approximator</td><td>pharmap</td><td>UD-04-275</td><td>modified Kocher&#039;s forceps&lt;br/&gt; &lt;a href=&quot;http://pharmap.ch&quot; target=&quot;_blank&quot;&gt;pharmap.ch&lt;/a&gt;</td></tr></tbody></table>

manufacturing devices and instruments for easier rat liver transplantation

Manufacturing Devices and Instruments for Easier Rat Liver Transplantation

Orthotopic rat liver transplantation is a popular model, which has been shown in a recent JoVE paper with the use of the "quick-linker" device. This technique allows for easier venous cuff-anatomoses after a reasonable learning curve. The device is composed of two handles, which are carved out from scalpel blades, one approximator, which is obtained by modifying Kocher's forceps, and cuffs designed from fine-bore polyethylene tubing. The whole process can be performed at a low-cost using common laboratory material. The present report provides a step-by-step protocol for the design of the required pieces and includes stencils.

Five kits, including five approximators and 11 handles have been manufactured. One handle broke during the final brushing. This problem was due to the fact that the ring of the handle was too narrow, and it has been solved by setting the narrowest part of the handle ring at 0.5 mm. No problems occurred during the shaping of the approximators.
<table border="1">
<tbody>
 <tr>
 <td>Rat weight 
 (g)</td>
 <td>Porta handle (inner dia) 
 (mm)</td>
 <td>Porta cuff 
 (outer dia) 
 (mm)</td>
 <td>IVC handle (inner dia) 
 (mm)</td>
 <td>IVC cuff 
 (outer dia) 
 (mm)</td>
 </tr>
 <tr>
 <td>120-180</td>
 <td>2.2</td>
 <td>1.7</td>
 <td>2.6</td>
 <td>2.08</td>
 </tr>
 <tr>
 <td>180-270</td>
 <td>2.6</td>
 <td>2.08</td>
 <td>3.4-3.7</td>
 <td>3.0-3.25</td>
 </tr>
 <tr>
 <td>&gt;270</td>
 <td>2.9</td>
 <td>2.42</td>
 <td>4.2</td>
 <td>3.7</td>
 </tr>
 </tbody>
</table>
Table 1.
<img src="/files/ftp_upload/50380/50380fig1.jpg" alt="Mechanical component diagram with precise dimensions and gear design layout." fo:content-width="6in" fo:src="/files/ftp_upload/50380/50380fig1highres.jpg" data-altupdatedat="1787630408000" data-alt="Figure 1"> 
Figure 1. Porta handle stencil. If printed with a scale 1:1 can be used to guide the handle shaping. <a href="https://www.jove.com/files/ftp_upload/50380/50380fig1large.jpg" target="_blank">Click here to view larger figure</a>.
<img src="/files/ftp_upload/50380/50380fig2.jpg" alt="Structural design diagram; engineering measurement, technical layout, mechanical dimensions." fo:content-width="6in" fo:src="/files/ftp_upload/50380/50380fig2highres.jpg" data-altupdatedat="1787630408000" data-alt="Figure 2"> 
Figure 2. IVC handle stencil. If printed with a scale 1:1 can be used to guide the handle shaping. <a href="https://www.jove.com/files/ftp_upload/50380/50380fig2large.jpg" target="_blank">Click here to view larger figure</a>.
<img src="/files/ftp_upload/50380/50380fig3.jpg" alt="Mechanical engineering static equilibrium diagram with dimensions and component measurements." fo:content-width="4.6in" fo:src="/files/ftp_upload/50380/50380fig3highres.jpg" data-altupdatedat="1787630408000" data-alt="Figure 3"> 
Figure 3. Porta and IVC cuffs lateral view. Graft's v.porta should be secured to the central groove, while recipient's vessel to the lateral one. This expedient allows for optimal intima-to-intima contact.
<img src="/files/ftp_upload/50380/50380fig4.jpg" alt="Technical drawing of two concentric circles with diameter labels; engineering diagram." fo:content-width="4.1in" fo:src="/files/ftp_upload/50380/50380fig4highres.jpg" data-altupdatedat="1787630408000" data-alt="Figure 4"> 
Figure 4. Porta and IVC cuffs front view. Calipers suitable for rats weighing 180-270 g are represented.

We describe the design of the &#x201C;quick-linker&#x201D; device for easier orthotopic rat liver transplantation.

Orthotopic rat liver transplantation is a popular model, which has been shown in a recent JoVE paper with the use of the "quick-linker" device. This ...

In a Recent video paper on Jo, we described the use of the quick linker device for easier rat liver transplantation. The device is not available on the market, however it can be manufactured without professional skills. In this video, we describe how to design and shape a complete kit starting from common laboratory material.Enjoy the video. The quick linker kit for orthotopic rat liver transplantation is composed by one approximator, one ring for the repath VNA cava, and a smaller one for the vena portal, secure a number 10 scalpel blade on a wooden board with a tape tuck the center of the ring under the microscope. It should be located 1.2 centimeter straight from the groove of the scalpel.Mount a diamond bit on a high speed rotating and drill and drill at two millimeters hole. Widen the hole with fuser iconic diamond bits. The whole diameter should be 2.6 millimeters for the portal handle of rat's wage in between 180 and 240 grams.Design the external shape of the handle as shown in the stencil. Enclosed in figure one, convert the drill into a mini bench grinder and remove the part of the blade outside the shape. Finally, round of the piece with a low speed rotating brush.The approximator is obtained by modifying straight surgical climbs or caucus forceps at off half of one branch under the microscope. Using the high speed mini bench grinder, make symmetrical grooves on both sides to allow for the handle to slide in completely. Cut a longitudinal slit into the long arm and check that the center of the long arm and the well positioned handle are on the same axis.Design a notch on the long arm facing the center of the end. Make the branch as thin as possible. Finally, round of the piece with a low speed rotating brush, rush calf calipers vary according to the rat weights and strains.However, the land should always be kept around four millimeters. Refer to table one for caliber ranges. Take a fine bo Polyline tubing and round off one edge with a number 10 scalpel.Design a groove at a 0.5 millimeters from the edge. Now carefully cut out as lo going down to the groove. Cut out one or two full thickness nicks into the tubing.These will help manipulating the calf during graft preparation and transplantation. Finally cuts the calf at four millimeters from the edge. We showed how to build a kit composed by a ring for the portal vein and its calf, a ring for the hepatic vena cava and its calf and one approximator.These tools facilitate liver reimplantation by assisting calfs insertion. All metal parts are removed just after fusion, so the kit can be unlimitedly reused no matter what ring size or shape variation you choose. Alignment to the approximator is the most critical factor.Another important factor is the thickness of the grooves, which shouldn't be thinner than 0.5 millimeters during, in the bottom of the picture, for example, has been correctly shaped by contrast. In the top one. The metal bridge between two segments is too thin and might lead to a rupture during the phase of final brushing, as in this case following the measures.Given no problems should occur and the instruments may potentially last forever.

manufacturing-devices-instruments-for-easier-rat-liver

Research

JoVE Journal

Bioengineering

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The goal of this study is to modify the rat orthotopic liver transplant model to better represent human liver transplantation and improve recipient survival. The presented method reestablishes hepatic arterial inflow by connecting the donor liver's common hepatic artery to the recipient liver's proper hepatic artery.

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This paper provides a detailed description of how to build an animal model of the anhepatic phase (liver ischemia) in rats to facilitate basic research into ischemia-reperfusion injury after liver transplantation.

Organ Ischemia-Reperfusion Injury by Simulating Hemodynamic Changes in Rat Liver Transplant Model

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Learn to manufacture the quick-linker device for orthotopic rat liver transplantation using common laboratory materials. This accessible kit improves surgical efficiency and enables unlimited reuse for researchers.

Manufacturing Devices and Instruments for Easier Rat Liver Transplantation

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