Gastrectomy - How it's performed 

How a gastrectomy is performed 

There are different types of gastrectomy, depending on which part of your stomach needs to be removed.

Types of gastrectomy

There are four main types of gastrectomy, all of which are carried out under general anaesthetic (painkilling medication that makes you unconscious):

  • partial gastrectomy
  • total gastrectomy
  • sleeve gastrectomy
  • oesophagogastrectomy

Partial gastrectomy

During a partial gastrectomy, the surgeon will make a cut into your abdomen (tummy) before removing the lower half of your stomach.

If you have stomach cancer, nearby lymph nodes are also usually removed as there is a risk that the cancer may have spread to the nodes.

Your surgeon will then stitch the upper part of your stomach to your small intestine (small bowel).

Total gastrectomy 

During total gastrectomy, your surgeon will make a cut into your abdomen before removing your stomach. They will then connect your oesophagus (the tube between your throat and stomach that food passes down) directly to your small intestine (small bowel).

Sleeve gastrectomy

During sleeve gastrectomy, the surgeon will make a cut into your abdomen before removing the left side of your stomach. This can reduce your stomach's volume by up to 75%. This operation is usually performed using keyhole surgery.

The remaining part of your stomach is pulled upwards and resealed using stitches. This creates a much smaller and longer stomach that looks like a banana.

Oesophagogastrectomy

An oesophagogastrectomy is used to remove the upper section of the stomach and part of the oesophagus.

The lower part of your stomach is pulled upwards and attached to the end of your oesophagus.

Techniques for gastrectomy

Two different techniques can be used to carry out gastrectomy:

  • open gastrectomy – where a large cut is made in your abdomen or chest
  • keyhole surgery (laparoscopic gastrectomy) – where several smaller cuts are made and special surgical instruments are used

A laparoscopic gastrectomy is also sometimes known as a laparoscopically assisted gastrectomy (LAG).

Open vs keyhole surgery

There are pros and cons of each type of surgery. People who have keyhole surgery usually recover more quickly and have less pain after the procedure than those who have an open gastrectomy. You may also be able to leave hospital slightly earlier. Complication rates after keyhole surgery are similar to those for open gastrectomies.

Keyhole surgery is an advanced surgical technique that requires specialised training and equipment. The operation may take longer if it is carried out using keyhole surgery.

Open gastrectomies are usually more effective in treating advanced stomach cancer compared with keyhole surgery. This is because it is usually easier to remove affected lymph nodes (small glands that are part of the immune system) during an open gastrectomy.

Before you decide which procedure to have, discuss the advantages and disadvantages of both techniques with your surgeon.

Page last reviewed: 09/11/2012

Next review due: 09/11/2014

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