Gastrectomy Surgery

Gastrectomy is a surgical procedure involving removing all or parts of the stomach. The stomach is a J-shaped organ of your body on the left side of the upper abdomen and is a part of the digestive system. Gastrectomy treats several stomach-related problems that do not resolve through other non-surgical treatments. Removing your stomach does not mean you must compromise on what you eat and drink; however, you must make certain lifestyle changes after the procedure.

Read to know more about gastrectomy, when it is recommended, the various types of gastrectomy procedures, how it is performed, and the benefits and risks involved.

“Ectomy” means removal of a part of your body, and “gastro” means stomach. Thus, gastrectomy is a medical procedure for removing all or parts of your stomach when diseased. It is performed to treat stomach cancer and the perforations of the stomach wall. Different techniques of gastrectomy are performed depending on the reason for the surgery and the extent and severity of the pathological disease of the stomach.

Gastrectomy is a surgical intervention carried out to remove the whole or part of your stomach when other non-surgical treatments fail. Your doctor may recommend gastrectomy for the following reasons:

• Benign (non-cancerous) lesions, cysts, and tumors
• Perforations in the stomach wall
• Severe ulcers present in different parts of your stomach 
• Severe inflammation of the stomach causing pain and bleeding
• Abnormal lumps, polyps, or growths inside your stomach
• Some types of gastrectomy also treat obesity (being overweight) when other approaches (diet, exercise) fail. The stomach size is reduced to make it smaller so that it fills more quickly, which makes you eat less. 

Depending on the part of your stomach that needs to be removed, gastrectomy is one of four types:

Partial Gastrectomy

• The lower part of your stomach is removed in this technique.
• In this procedure, your surgeon will close your duodenum (the first part of your small intestine that receives partially digested food from your stomach. 
• The remaining part of your stomach will be connected to your bowel.

Complete Gastrectomy

• This procedure, also known as total gastrectomy, removes your complete stomach, and the esophagus is directly connected to your small intestine.

Sleeve Gastrectomy

• In this procedure, almost 3/4th of your stomach is removed and your surgeon will trim the sides of your stomach and change the shape that resembles a tube.
• This creates a smaller and longer stomach.
• This type of gastrectomy is recommended to treat obesity.

Oesophagogastrectomy 

• Here the top part of your stomach and a part of your esophagus is removed. Esophagus (food pipe) is a tube that connects your throat to your stomach through which food passes down to the stomach.

It is important to know certain facts about the pre-procedure preparation of a gastrectomy to ease your anxiety for a smooth and speedy recovery post-procedure.

•  Before the surgery, your surgeon will conduct a physical examination and certain blood tests and scans to determine your overall health. These tests include complete blood count, bleeding and clotting time, ultrasound scan of the abdomen and pelvis, and CT (Computed Tomography) scan.
• Your surgeon will review your medical history for pre-existing conditions like diabetes (increased sugar levels), hypertension (high blood pressure), or bleeding disorders.
• You need to inform your surgeon if you are pregnant, or allergic to any medication, and also about the medications that you have been taking (blood thinners, vitamin supplements, etc).
• Avoid smoking, and excess alcohol consumption at least 2 weeks before the procedure that can delay your recovery.
• You are likely to receive an enema one night before the surgery, and you are also advised to fast overnight.
• Intravenous (IV) fluids are administered to keep you hydrated.

A gastrectomy is done under general anesthesia (a numbing agent to sedate you completely). Once you are put to sleep, the procedure begins:

• A nasogastric tube (thin medical tube) is inserted into your stomach through the nose to empty the contents.

Open Gastrectomy

• An incision or cut is made from the upper to the lower abdomen, to expose the stomach.
• Depending on partial or total gastrectomy, the complete or diseased part of the stomach is removed.
• Adjacent areas are checked for any spread of the disease.
• Once the surgery is complete, the incision is closed with sutures (stitches), and a surgical, waterproof dressing is placed over it.

Laparoscopic Gastrectomy 

• Your surgeon makes keyhole-sized incisions near your abdomen through which a laparoscope is inserted through one cut and surgical instruments through other cuts.
• A laparoscope is a thin tube with a tiny camera and a light source at the end.
• The camera sends images to a large screen projection which helps the surgeon to visualize the surgical site and perform the surgery.
• The cuts are closed with small stitches.

The length of your hospital stay depends on the extent of the stomach removed, which usually ranges between 3 to 7 days.

• A nasogastric tube is inserted through your nose and into the intestines to drain the fluids for a day or two if your entire stomach is removed.
• IV fluids are continued until you are able to eat and drink normally.
• You are likely to be given a liquid diet until your stay in the hospital.
• A light diet should normally begin after the first week.
• It is normal to experience pain which can be managed through pain relief medications.
• You are advised to avoid lifting heavy objects and strenuous activities for at least 6 weeks.
• Avoid driving while you are on pain medications.
• You are advised to consult a dietician who will guide you about your meal plans. Consume smaller meals 5 to 6 times a day for proper digestion.
• You may need Vitamin B12 injections after the surgery because post-surgery, there are chances that your vitamin B12 levels may decrease and if not taken care of, will lead to anemia (a condition where there are fewer red blood cells present to deliver oxygen to the body ).
• Recovery may take 4 weeks to 6 weeks for Partial gastrectomy; 6 months to 1 year for complete gastrectomy; 4 weeks to 6 weeks for sleeve gastrectomy and 6 weeks to 8 weeks for oesophagogastrectomy.

As with other procedures, a gastrectomy also comes with its own set of risks and benefits.

Benefits

• Gastrectomy is used for multiple reasons and not just confirmed for medical reasons.
• It is a life-changing procedure for those who want to lose weight
• The laparoscopic approach is a minimally-invasive treatment with less trauma and faster recovery.
• It helps to prevent the spread of stomach diseases like cancer and ulcers to adjacent structures and organs.

Risks

• Mild to severe bleeding
• Infection near the surgical site causing pus discharge
• Leaking of digestive fluids, food, and liquids
• Stomach acids can seep up to the esophagus causing heartburn
• You may have a type of diarrhea called dumping syndrome
• Infections in your lungs
• Blood clots may travel to your lungs causing breathing difficulties (pulmonary embolism)
• Nausea, vomiting, and weight loss

Get treated by some of the country's best yet most experienced doctors! Our General, Gastrointestinal, and Laparoscopic Surgeons team are 15+ years certified and trained surgeons who have extensively performed various gastrectomy procedures for over a decade. Our surgeons suggest the most advanced surgical procedures that are painless, scarless, and ensure a speedy recovery. Think Surgery!! Think Medfin !!