Ileal transposition and SHAM surgery

The surgery procedures were performed as previously described by Grüeneberger et al. and Stygar et al.^43,59. Briefly, 2% isoflurane with 2 l/min oxygen flow under spontaneous breathing was used to induce and maintain anaesthesia; analgesia was performed with xylazine (5 mg/kg b.w., ip; Xylapan, Vetoquinol Biovet, Poland) and antibiotic prophylaxis with gentamicin (5 mg/kg b.w., im, KRKA, Poland). After an abdominal midline incision (length 4–5 cm) was performed, the Bauhin’s valve was identified. Then 50% of the distal ileum was located and transected. The ileal continuity was restored by an end-to-end extramucosal anastomose using PDS 6/0 (Ethicon Endo-Surgery Inc. USA) and the transposed segment was excluded. Then, the ligament of Treitz was identified and the jejunum was divided 5 cm aborally. The transposed segment of ileum was inserted in an isoperistaltic fashion and two end-to-end anastomoses were performed (Fig. 5). For control (SHAM) surgery, transections were performed at all three analogous points, anastomoses were completed correspondingly, nevertheless without IT (Fig. 5). Fascia and skin closures were performed with a continuous suture using Monocryl 4/0 and Vicryl 4/0. After the surgery, all rats were kept on a liquid diet for 24 h (Nutrison, Nutricia, Poland).

Scheme of ileal transposition (IT) and control (SHAM) surgery performed in Zucker (Crl:ZUC(ORL)-Lepr^fa) rats. Detailed description of each type of surgery can be found in the “Materials and method” section.