Roux-en-Y gastric bypass surgery in rats: findings from the literature and practical insights from a structured surgical training program

Roux-en-Y gastric bypass (RYGB) in rats is a valuable model for studying the complex physiological and metabolic effects of bariatric surgery. However, performing RYGB in rats is technically challenging and associated with variable postoperative mortality. We conducted a non-systematic review of original studies on rat RYGB published between 2013 and 2023 to identify procedural and perioperative factors associated with reported mortality. Seventy publications met the inclusion criteria, reporting a median mortality of 24% (range 0-60%). Specific surgical parameters associated with reported mortality were identified and subsequently standardized in the training program. This program comprised three sequential modules, progressing from microsurgical training using artificial materials and cadavers to non-survival RYGB procedures and finally to survival RYGB surgery with postoperative monitoring. The progression of one inexperienced trainee through the program was documented to demonstrate progressive acquisition of technical skills. Overall, the structured training program incorporates literature-identified surgical parameters associated with reported mortality and provides a standardized framework for acquiring the technical and perioperative skills needed to perform rat RYGB while promoting animal welfare and refinement.