Gastrectomy is the removal of part or all of the stomach.
There are three main types of gastrectomy:
- A partial gastrectomy is the removal of a part of the stomach. The lower half is usually removed.
- A full gastrectomy is the removal of the entire stomach.
- A sleeve gastrectomy is the removal of the left side of the stomach. This is usually performed as part of a surgery for weight loss.
Removing your stomach doesn’t take away your ability to digest liquids and foods. However, you may need to make several lifestyle changes after the procedure.
Gastrectomy is used to treat stomach problems that aren’t helped by other treatments. Your doctor may recommend a gastrectomy to treat:
- benign, or noncancerous, tumors
- perforations in the stomach wall
- polyps, or growths inside your stomach
- stomach cancer
- severe peptic or duodenal ulcers
Some types of gastrectomy can also be used to treat obesity. By making the stomach smaller, it fills more quickly. This may help you eat less. However, gastrectomy is only an appropriate obesity treatment when other options have failed. Less invasive treatments include:
There are three major types of gastrectomy.
Your surgeon will remove the lower half of your stomach during a partial gastrectomy. They may also remove nearby lymph nodes if you have cancer cells in them.
In this surgery, your surgeon will close off your duodenum. Your duodenum is the first part of your small intestine that receives partially digested food from your stomach. Then, the remaining part of your stomach will be connected to your bowel.
Also called total gastrectomy, this procedure completely removes the stomach. Your surgeon will connect your esophagus directly to your small intestine. The esophagus normally connects your throat to your stomach.
Up to three-quarters of your stomach may be removed during a sleeve gastrectomy. Your surgeon will trim the side of your stomach to turn it into a tube shape. This creates a smaller, longer stomach.
Your doctor will order blood tests and imaging tests before the surgery. These will ensure you’re healthy enough for the procedure. You’ll also have a complete physical and a review of your medical history.
During your appointment, tell your doctor if you’re taking any medications. Be certain to include over-the-counter medicines and supplements. You may have to stop taking certain drugs prior to surgery.
You should also tell your doctor if you’re pregnant, think you could be pregnant, or have other medical conditions, such as diabetes.
If you smoke cigarettes, you should stop smoking. Smoking adds extra time to recovery. It can also create more complications, especially those involving infection and lung problems.
There are two different ways to perform gastrectomy. All are performed under general anesthesia. This means you’ll be in a deep sleep during the operation and you won’t be able to feel any pain.
Open surgery involves a single, large incision. Your surgeon will pull back skin, muscle, and tissue to access your stomach.
Laparoscopic surgery is minimally invasive surgery. It involves small incisions and specialized tools. This procedure is less painful and allows for a quicker recovery time. It’s also known as “keyhole surgery” or laparoscopically assisted gastrectomy (LAG).
LAG is usually preferred to open surgery. It’s a more advanced surgery with a lower rate of complications.
Your surgeon may recommend open surgery over laparoscopic surgery to treat certain conditions, such as stomach cancer.
The risks of a gastrectomy include:
- acid reflux
- gastric dumping syndrome, which is a severe form of maldigestion
- an infection of the incision wound
- an infection in the chest
- internal bleeding
- leaking from the stomach at the operation site
- stomach acid leaking into your esophagus, which causes scarring, narrowing, or constriction (stricture)
- a blockage of the small bowel
- vitamin deficiency
- weight loss
- difficulty breathing
- damage to adjacent structures
Make sure you tell your doctor about your medical history and what medications you’re taking. Follow all of the directions you’re given to prepare for the procedure. This will minimize your risks.
After the gastrectomy, your doctor will close your incision with stitches and the wound will be bandaged. You’ll be brought to a hospital room to recover. A nurse will monitor your vital signs during the recovery process.
You can expect to stay in the hospital for one to two weeks after the surgery. During this period, you’ll likely have a tube running from your nose to your stomach. This allows your doctor to remove any fluids produced by your stomach. This helps keep you from feeling nauseated.
You’ll be fed through a tube in your vein until you’re ready to eat and drink normally.
Tell your doctor immediately if you develop any new symptoms or pain that’s not controlled with medication.
Once you go home, you may have to adjust your eating habits. Some changes may include:
- eating smaller meals throughout the day
- avoiding high fiber foods
- eating foods rich in calcium, iron, and vitamins C and D
- taking vitamin supplements
Recovery from a gastrectomy can take a long time. Eventually, your stomach and small intestine will stretch. Then, you’ll be able to consume more fiber and eat larger meals. You’ll need to have regular blood tests after the procedure to make sure that you’re getting enough vitamins and minerals.