Elevating surgical standards with an iterative workshop on good practice for rodent surgery

Surgery is an integral part of many experimental studies. Good surgical practice is a prerequisite for surgical success and optimal animal welfare. It also impacts validity and reproducibility of scientific knowledge acquired using laboratory animals.              

Rodents – especially mice - are the most common experimental animal, representing 69% of animals used in research in Switzerland in 2022. While legislation treats experimental surgery requirements the same for both rodents and large animals, differences in daily practice reveal variations in surgical hygiene and adherence to good practices based on the species or size of the patient. Additionally, it is generally accepted that aseptic technique used during surgery minimises the contamination with micro-organisms, thus preventing postoperative wound infection.

The principles of good surgical practice introduced nearly 200 years ago are still valid and are standard practice in human as well as veterinary surgery. These include surgical hand disinfection, sterile gowning and glowing, decontaminating and draping the subject before surgery, as well as using sterile equipment.  Because of the importance of this practice in animal research, Dr. Petra Seebeck, head of the Zurich integrative Rodent Physiology (ZIRP) of the University of Zürich, and Dr. Stephan Zeiter, program manager of the Preclinical Services program at the AO Research Institute Davos (ARI), investigated how good surgical practice was implemented in laboratories working with rodents.

The Swiss 3RCC, whose mission is to support the development and implementation of effective 3Rs methods, supported their initiative by awarding the grant “Rodents have a right to best surgical practice” in response to the Open Call 2018 (OC-2018-002). This grant empowered Petra and Stephan to perform a systematic review to identify, critically evaluate and compare currently recommended standards as well as guidelines for rodent surgery. In tandem, through online surveys, they collected data about the demographics, workplace environment and working conditions of persons employed in the field of experimental rodent surgery.

The information obtained with the surveys and the systematic review unveiled that more than 60% of the researchers performing rodent surgery have no medical (MD or DVM) background. It can therefore be assumed that they do not receive any surgical training during their education. Furthermore, good surgical practice seems to be poorly applied during surgery on rodents, and official guidelines on rodent surgery are inconsistent on top of being hardly available in Europe. Consequently, dedicated training and guidelines need to be developed and provided to address the specific case of experimental rodent surgeons. Petra and Stephan also realized that available infrastructures, facility workflows, as well as attitude and behavior play a vital role for implementing good surgical practice. This requires cooperation with relevant stakeholders such as facility managers, designated veterinarians, and animal welfare bodies.

In 2022, they* started to offer a training course for “Good Surgical Practice for Rodent Surgery”. In this one-day course, combining lectures with practical parts, the participants learnt to perform surgical hand disinfection, sterile gowning and glowing, proper decontamination and draping of the subject before surgery, as well as usage of sterile equipment. They first practice in separate steps and at the end, all steps are combined into one sequence. The course takes place only in small groups to increase the practical learning experience. A special emphasis is put on experimental rodents, where specific conditions must be considered. These comprise e.g. many identical surgeries to be performed at the same day (‘batch surgery’), the use of genetically modified or immunocompromised rodents, the need for a specific (micro)surgical set up and dedicated instruments due to the animals’ small size. Additionally, tips and tricks on materials and procedures are offered. The instructors aim at establishing an open culture, fostering questions and intense discussions.  

This one-day course already took place three times in Zurich in September 2022 and 2023. Following its success, it was repeated in December 2023 in Geneva with the coordination of Dr. Daniele Roppolo, director of Animal Experimentation at the University of Geneva, and Dr Elsa Giobellina, Animal Welfare Officer. In total, 80 participants nationwide could benefit from these courses. Further sessions will be organized in 2024 with the aim to cover all regions of Switzerland. For the future, the training team plans to complement this course by providing materials such as video tutorials and posters including high-quality pictures. Additionally, the participants expressed their interest in more specific or advanced courses (dedicated specific surgical procedures), which could be envisioned.

By funding this project, the Swiss 3RCC played a pivotal role in enabling both refinement with a direct improvement on animal welfare, and reduction of animal numbers driven by better study validity and outcomes.  Besides, the training team strongly believes that only in-depth training (ideally with regular re-trainings) enables the adaptation of a good surgical practice and implementation of it into one’s individual surgery practices. Once internalized, these colleagues will use good surgical practice by default and adapt it to different surgical procedures. This approach integrates fully with the Swiss 3RCC’s goal of changing mindsets through education and targeted research funding at the national scale.  In addition, it shows the essential role of its node institutions, namely the Universities of Zurich and Geneva, in developing and implementing 3R practice in research.

*The course is provided by Charlotte Calvet, Felix Gantenbein, Tim Buchholz, Philipp Villiger, Petra Seebeck & Stephan Zeiter