Gastrectomy (Stomach-Removal)

A gastrectomy is the surgical removal of the stomach. There are two types: partial and total. During a partial gastrectomy, only a portion of the stomach is removed. However, in a total gastrectomy, the whole stomach is removed. Which you will need depends on your condition and underlying diseases. Some reasons to have a gastrectomy:

• Cancer in the stomach walls
• Bleeding in the stomach that has not responded to any other treatments
• To treat severe obesity

The stomach is in the top-left section of the abdomen. It is divided into 5 parts, each with its own type of cells and function in digestion.

Paraclinical testing before a gastrectomy

First, your doctor will order an endoscopy to examine your digestive tract. He/she may take a tissue sample during the endoscopy if it is needed. CT scanning, MRI, and other imaging techniques may be used to assess the conditions of the surrounding organs. You must also get a full blood test before the surgery.

Preoperative care, the procedure, postoperative care

Before the procedure

Start fasting the night before the procedure. You will wear a hospital gown and be taken to the operating room. This procedure is done under general anesthesia. A cuff to monitor blood pressure will be attached to your arm. In addition, a device to monitor heart rate, oxygen levels and blood pressure will be attached to your finger.

The gastrectomy procedure

A gastrectomy can be done either as a laparoscopic surgery or an open surgery. During a laparoscopy, 4 incisions are made in your abdomen through which a probe (a thin tube with a camera) and the surgical tools are inserted. The advantage of having a laparoscopy is that it has a shorter recovery time.

The surgeon may decide that an open surgery is more fitting for your condition. In this case, a longer incision is made in your abdomen, giving the surgeon direct access to your stomach.

After removing the stomach, the surgeon will connect the remaining parts of the digestive tract and close the incision(s).

After the procedure

You will be moved to the recovery room as soon as you wake up. Then, you will be transferred to the ICU to be closely supervised for 1-2 days until your condition is stable enough for you to be moved to the ward.

You will get most of your nutrition through an IV in your vein to avoid putting pressure on your digestive system. When your doctor decides that your condition has improved, you can slowly start to consume liquids and then soft foods for around 1-2 days.

After a gastrectomy, you must have several small meals throughout the day rather than 3 large ones. Reduce your carbohydrate intake and increase your fat and protein intake. You can consult a nutritionist to give you a proper meal plan.

Important notes regarding gastrectomy

Based on your situation, you may need a feeding tube. This tube goes straight through your skin and to the intestines. It is used to supply nutrition and medication. The tube should be set up correctly to avoid infection. You must follow the diet that your doctor will give you so that your digestive system can adapt to the new circumstances.

If you had a gastrectomy to treat stomach cancer, you may need to have a few sessions of chemotherapy.

Notify your doctor if you experience the following symptoms after the procedure:

• Nausea
• Vomiting
• Fever
• Low blood pressure
• High heart rate
• Progressively increasing stomach pain

Duration of hospitalization

After a gastrectomy, you will stay in the hospital for around 4-6 days.