Gastrectomy

What is a gastrectomy?

A gastrectomy is the surgical removal of part or all of the stomach. Your doctor may recommend a gastrectomy to treat cancer, severe ulcers, benign tumors, and other conditions that damage the stomach. Your doctor may perform a gastrectomy for some ulcers of the small intestine just after your stomach. A gastrectomy can also help treat obesity and prevent stomach cancer from occurring in certain high-risk people.

Your stomach is the organ responsible for digesting food that you swallow through your esophagus. It passes digested food on to your small intestine for further processing.

Gastrectomy is a major surgery with significant risks and potential complications. You may have less invasive treatment options and should consider getting a second opinion about all of your treatment choices before having a gastrectomy.

Types of gastrectomy

The types of gastrectomy procedures include:

• Partial gastrectomy is the removal of part of the stomach. Your doctor then attaches your small intestine to the remaining healthy part of the stomach.
• Total gastrectomy is the removal of the entire stomach. Your doctor then attaches the small intestine to the esophagus.
• Sleeve gastrectomy (also called vertical sleeve gastrectomy and stomach stapling) is the removal of a large part of the stomach to help with weight loss. Your doctor uses staples to create a smaller stomach then attaches the small intestine to the remaining stomach.

Why is a gastrectomy performed?

Gastrectomy is a major surgical procedure that your doctor may recommend to treat certain diseases and conditions of the stomach and sometimes the small intestine. Your doctor may only consider gastrectomy if other treatment options that involve less risk of complications have been ineffective. Talk with your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend a gastrectomy for:

• Benign tumors in the stomach
• Perforations (holes) and bleeding in the stomach caused by a severe peptic ulcer
• Stomach cancer, also known as gastric cancer
• Ulcers of the duodenum, the first part of the small intestine

Doctors sometimes recommend a total gastrectomy as a preventive measure for certain types of hereditary stomach cancer. These include hereditary diffuse gastric cancer.

A vertical sleeve gastrectomy can help treat severe obesity. This type of gastrectomy leads to weight loss by making the stomach smaller and limiting the amount of food you can consume.

How is a gastrectomy performed?              

A general surgeon, surgical oncologist, or bariatric surgeon will lead a team to perform your gastrectomy in a hospital. A bariatric surgeon is a physician who specializes in weight-loss surgery. A surgical oncologist has additional training in oncology, which involves the diagnosis and treatment of cancer. Your surgeon performs the procedure by making an incision in the abdomen to remove the damaged part of the stomach. He or she connects the small intestine to the remaining healthy part of the stomach. If your whole stomach needs to be removed, your surgeon will connect the small intestine to the esophagus.

Surgical approaches to gastrectomy

Your doctor will perform a gastrectomy using one of the following approaches:

• Minimally invasive surgery is a procedure performed by inserting special instruments and a laparoscope through small incisions in the abdomen. The laparoscope is a thin, lighted camera that transmits pictures of the inside of your body to a video screen. Your doctor sees the inside of your abdomen on the computer screen as he or she performs the surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. He or she can thread surgical tools around structures, such as muscle, instead of cutting through or displacing them as in open surgery.
• Open surgery is performed by making a large incision in the abdomen. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. This is because it causes more trauma to tissues. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.