Gastrectomy

Home » Gastrectomy » Overview, Surgical Procedure, Preoperative Care

Overview

Gastrectomy is the surgical removal of all or part of the stomach. This surgery is performed as a treatment for stomach cancer and may also be indicated for a bleeding gastric ulcer, a perforation (hole) in the stomach wall, and noncancerous polyps.

The stomach plays such a large role in digestion, that it may be hard to believe that this organ can be removed. Yet, a person can adjust to living without a stomach.

The stomach connects to the esophagus (tube that carries food from the mouth) on one end and the small intestine (primary site of nutrient absorption) on the other end. When part of the

stomach is removed, the remaining portion continues its digestive function. If the entire stomach is removed, the esophagus is attached to the small intestine, the digestive process begins in the small intestine, and the body eventually adapts. Dietary changes may be necessary.

General anesthesia is used to render the patient unconscious, so they do not experience pain and have no awareness during the operation. When the anesthesia has taken effect, a urinary catheter is usually inserted to monitor urine output. A nasogastric tube (i.e., a thin tube from the nose down into the stomach) is also put in. The abdomen is then cleansed with an antiseptic solution.

The surgeon makes a large incision from just below the breastbone to the navel. If the lower end of the stomach is diseased, the surgeon places clamps on either end of the area and that portion of the stomach is removed. The upper part of the stomach is then attached to the small intestine.

If the upper end of the stomach is diseased, the end of the esophagus and the upper part of the stomach are clamped. The affected portion is removed, and the lower part of the stomach is attached to the esophagus.

In a total gastrectomy, clamps are placed on the end of the esophagus and the end of the small intestine. The stomach is removed and the esophagus is joined to the intestine. Lymph nodes, a section of the pancreas, and the spleen are often removed in cases of cancer.

The abdomen is sutured. The nasogastric tube remains in place and is removed during the postoperative period. Surgery generally takes between 1 and 3 hours, depending on the diagnosis and the extent of the disease.

Prior to surgery, patients undergo preoperative testing, which may include x-rays, CT scans, ultrasonography, blood tests, urinalysis, and an EKG.

Medications that "thin" the blood, such as aspirin, are discontinued several days prior to the operation. Other

drugs, such as insulin for diabetes, may be withheld the day of surgery. As soon as the decision to undergo surgery is made, medication usage should be discussed with the physician.

The stomach must be completely empty before the operation begins to avoid vomiting that can occur during the procedure. Patients must abstain from solid food and liquid after midnight on the evening before the operation.

Upon arrival at the hospital (usually the day before surgery), patients must sign an informed consent form acknowledging that the procedure and risks have been explained and that they are aware that they will receive anesthesia and possibly other medications.

The anesthesiologist (i.e., doctor who administers anesthesia) speaks to the patient prior to surgery and performs a brief physical assessment. The anesthesiologist needs to know about medications being taken, any history of allergies, and previous adverse reactions to anesthesia. The patient's physical condition and history determines the choice and dosage of anesthesia and whether special precautions need to be taken.

An intravenous (IV) is started in the patient's room or in the preoperative area. Sedation is given by injection or through the intravenous to induce relaxation and cause drowsiness. Anesthesia is administered in the operating room.

Gastrectomy Resources

	Join Our Gastrectomy Forum Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others.	Advertising Disclaimer
	Living with...Share your story Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections.
	Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Help others by sharing your story. View stories already submitted. June 1st is National Cancer Survivors Day Share your survival story and help others in the fight against cancer. Read cancer survivor stories already submitted.
	Stay Updated Sign up for our newsletter and receive important updates on the medical conditions that are most important to you.
Are you interested in becoming a nurse? Take this test. Advertising Disclaimer To quickly access health information from your website's browser, download Healthcommunities.com's healthchannels toolbar. Advertising Disclaimer