Sleeve Gastrectomy in Mice Using Disposable Ligature Clips

Summary

Here, we present a protocol that utilizes a disposable ligature clip to create a mouse sleeve gastrectomy model. This model demonstrates low postoperative mortality, shorter operative time, and therapeutic outcomes comparable to traditional suturing techniques.

Abstract

Current mouse models of sleeve gastrectomy (SG) rely heavily on manual suturing -- a technically demanding procedure with prolonged operative times, high perioperative mortality, and a steep learning curve. This limits their accessibility to non-surgical researchers. To address this bottleneck, we developed a simplified SG protocol using disposable ligature clips, commonly employed in clinical gastrointestinal surgery. In diet-induced obese C57BL/6J mice, the clip-based approach reduced mean operative time by >50% (20.9 ± 3.2 vs. 43.9 ± 3.0 min) and significantly improved 12-week survival compared to traditional suturing. The method achieved equivalent metabolic outcomes, including sustained weight loss, improved glucose tolerance, enhanced insulin sensitivity, and reduced hepatic steatosis. Notably, the model requires no specialized microsurgical expertise or stapling devices, which are often unavailable for murine applications. We recommend this clip-based method for investigators, particularly those without advanced surgical training, who prioritize procedural efficiency and reproducibility in mechanistic studies of bariatric surgery. For surgeons seeking direct clinical translatability, suture-based techniques remain preferable, albeit with more stringent perioperative management.

Introduction

Bariatric surgery is widely acknowledged as the most effective intervention for extreme obesity and its associated complications¹. The mouse sleeve gastrectomy (SG) model is a valuable tool for studying the pathophysiological changes and potential mechanisms associated with bariatric surgery. This model is advantageous because it allows the use of genetically modified mouse strains, such as those with gene knockouts or overexpression. Mouse models that are easy to replicate, enable strict control of experimental conditions, and facilitate experimental manipulation are essential for clinical translation².

Protocol

This protocol adheres to the International Animal Welfare Ethics Guidelines and has been approved by the Jinan University Experimental Animal Welfare and Ethics Committee (Approval Number: 20240227-0073).

NOTE: Thirty male C57BL/6J wild-type mice (eight weeks old), weighing 22-25 g, were housed in a specific pathogen-free (SPF) environment with a room temperature of 20-26 °C and 12/12 h alternating day/night. After acclimation to a high-fat diet for 4 weeks, the mice were randomly assigned to SC (SG with clip), SS (SG with suture), and SH (sham) groups with 10 mice in each group.

1. Preoperative prepar....

Results

The criterion for surgical success was defined as mice surviving for more than 4 weeks post-surgery without experiencing serious complications. Deaths that occurred after the fourth postoperative week are attributed to complications. During 12 consecutive weeks of postoperative observation, one death was recorded in the SC group on the 24th postoperative day due to wound and abdominal infection caused by sutures, while the remaining nine mice survived until the 12th week. In the SS group, a total of five mice died, with .......

Discussion

A murine SG model was established using disposable ligature clips, resulting in a straightforward, efficient, and reproducible surgical procedure. The clip-based technique consistently demonstrated therapeutic efficacy comparable to that of the conventional suture-based SG model, while significantly reducing operative time and improving postoperative survival rates.

The operative technique for the mouse SG-suture model is not inherently complex, and many surgeons experienced in vascular suturi.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Anerdian solution	Prosperich	HC-3566	Sterilize chest and abdominal skin
75% alcohol	Macklin	E885996-500ml	Clean the surgical table
Animal anesthesia machine	YuyanBio	Yuyan-ABS	Mouse anesthesia equipment
Applicator	HangzhouKangji	Φ10 mm × 330 mm	Disposable ligature clip applicator
Disposable ligature clip	HangzhouKangji	KJ-JZJ02XL	Create a gastric sleeve
Electrosurgical pencil	YuyanBio	Gemini (battery-powered)	Electrocoagulation hemostasis during the operation.
Ensure	Abbott Laboratories	H20181147	Liquid diet
Glucometer and test strips	ACCU-CHEK	Guide Me	Blood glucose monitoring
GraphPad software	San Diego, CA, USA	GraphPad Prism 9	Data statistics and analysis
Heating pad	RTtech	RT-jr01	Maintain a warm body temperature for the mouse during surgery
High-fat diet	Research Diets, Inc	D12492	60 kcal% fat
Isoflurane	RWD	R510-22	Anesthetic drugs
Meloxicam	Aladdin	M129228-25g	Postoperative analgesic drugs
Microsurgical instruments	Beyotime	FS500	Perform animal surgery
Mouse retractor	CHIU POK	CP-ckq	Abdominal surgical retraction in mice
Surgical sutures	Jinhuan Medical	CR537/KCR631	Surgical sutures