The term “total gastrectomy” refers to the complete elimination or removal of the entire stomach, including all gastric tissues, nearby lymph nodes, and parts of the esophagus or small intestine. Total Gastrectomy is the most effective treatment for certain gastric tumors and cancers. This surgical procedure can prevent the cancers from spreading and also prevent them from coming back.
How is the surgery performed?
A total gastrectomy can be performed in different ways depending upon the patient’s conditions and surgeon preferences. Commonly used techniques involve open surgery or key-hole surgery (laparoscopy). During open surgery, the surgeon makes an incision from the upper mid-region of the abdomen to the naval region to expose the stomach and other internal organs. In patients with cancer, adjacent organs such as the liver and intestines including lymph nodes would be examined to check if cancer has spread. Then the surgeon will tie up the arteries in the surgical area along with lymph nodes. Then the surgeon will remove the entire stomach that is affected and after that will rejoin the upper cut end to a small bowel coop brought up, and close the cut with a few stitches, followed by draining of accumulated fluid. In the case of laparoscopic surgery, the surgeon will make multiple tiny incisions on the abdomen and will insert a laparoscope through one of the incisions, which allows the surgeon to view the inside of your abdomen on a screen. Using the images on the screen, the surgeon will then insert the necessary surgical tools through the other cuts and perform the procedure.
- The patients are advised to stop any type of medications or health supplements around a week before the surgery, especially those that make blood clotting difficult.
- Overnight fasting is required as the surgery is performed on an empty stomach.
- Some blood tests and other diagnostic tests may be advised by the surgeon before the procedure.
- The procedure requires hospitalization for a few days to weeks.
- The surgery is performed under general anesthesia wherein the patient is asleep and the procedure is completely painless.
Post-surgery, a tube is inserted into the nose that helps to keep the stomach empty. It is removed once the bowels start working well. Some patients suffer mild discomfort from the surgery which can be controlled with regular pain medications. Patients are usually hospitalized for 6-10 to ensure timely recovery . If the patient experiences symptoms such as high fever, excessive bleeding, vomiting, pain, or any other unusual symptoms, then immediate medical care or surgical care may need has to be taken. A dietician may advise to take small frequent and nourishing meals and avoid late-night eating to prevent reflux or heartburns. A follow-up appointment is generally planned within 1-3 weeks post-discharge.
Total gastrectomy involves certain risks such as: Post surgery bleeding infection.
- Blood clots in legs.
- Vitamin deficiency leads to complications such as weak bones and muscles, decreased immunity, or anemia.
- Weight loss.
- Incisional hernia.
- reflux, nausea, vomiting, or diarrhea.
- Dumping syndrome occurs when the food suddenly gets dumped into the small intestine due to the removal of some parts of the stomach leading to weakness, nausea, dizziness, and cold sweats.
- Narrowing of bowels due to scar tissue formation.