title: Establishing a reproducible large animal survival model of laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  The advent of metabolic surgery and the increasing focus on the substantial resolution rate of type 2 diabetes after laparoscopic Roux-en-Y gastric bypass (LRYGB) call for additional fundamental investigations as to the mechanisms behind this effect. These investigations require an adequate animal model. Our objective was to develop a reproducible survival model of LRYGB performed in a large animal at a tertiary university hospital.
  
  
  METHODS
  LRYGB was performed on 11 Yorkshire pigs that where then followed for 6 weeks. The operative time, morbidity, and mortality were recorded for each case. Necropsy was performed, and the anastomoses were harvested and inspected for leaks.
  
  
  RESULTS
  The surgical technique and difficulties are carefully described. Of the 11 pigs, 10 survived to the end of the study period. The 1 death was from intraoperative cardiac dysrhythmia. The postoperative complications consisted of a postoperative febrile episode in 2 pigs. The mean initial weight was 31.5 ± 3.4 kg. The mean operative time was 214 ± 71 minutes. No anastomotic leaks were identified at necropsy or on histologic examination of anastomoses. The mean weight gain at the end of the study period was .8 ± 1.4 kg compared with an expected 17.5 kg weight gain.
  
  
  CONCLUSIONS
  We have described an effective survival porcine model of LRYGB that can be consistently reproduced. This will enable additional investigation into the complex physiologic mechanisms that control hunger, weight loss, and the development, as well as resolution, of type 2 diabetes, potentially leading to the development of novel, targeted bariatric procedures and diabetic treatments.
authors: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
authors: Cesar E
authors: CE
authors: Escareno
authors: Dan E
authors: DE
authors: Azagury
authors: Richard S
authors: RS
authors: Flint
authors: Arthur
authors: A
authors: Nedder
authors: Christopher C
authors: CC
authors: Thompson
authors: David B
authors: DB
authors: Lautz
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery*; D004195:Disease Models, Animal; D015390:Gastric Bypass / Q000379:methods*; D007582:Jejunostomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications; D015203:Reproducibility of Results; D013270:Stomach / Q000601:surgery; D034421:Sus scrofa