Experimental metabolic surgery: justification and technical aspects.

ABSTRACT

BACKGROUND: Metabolic surgery is a surgical strategy which has shown great potential in the treatment of diseases which may be associated with morbid obesity. It must be developed on the basis of both animal and clinical research. The objective of this study is to set out the various options in experimentation animals and the technical characteristics in operations, and the specific animal care undertaken by our group. METHODS: We identified and reviewed the key points to be considered in animal handling during interventions such as sleeve gastrectomy, Roux-en-Y gastric bypass, ileal transposition and duodenal exclusion. RESULTS: The technical variations found at experimental level are due to the pouch capacity for the Roux-en-Y gastric bypass. Intestinal anastomosis is the variable with the greatest differences found between the various working groups. Ileal transposition is a technique that is undergoing constant review, and the results differ substantially depending on the animal model chosen, and are also metabolically effective in animals with a normal weight. Duodenal exclusion by means of a physical barrier has not been studied sufficiently but could be a pre-operative support for weight loss. CONCLUSIONS: There are experimental technical discrepancies and further studies are necessary to ascertain their efficiency. Metabolic surgery currently complements bariatric surgery and justifies the appearance of new experimental studies. The animal models chosen are very important as only very specific study models will be used in cases in which the technique is sufficiently validated by the research team, as the results to be assessed depend on this.