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 carried out under general anaesthetic (where you're unconscious):

  • partial gastrectomy
  • total gastrectomy
  • sleeve gastrectomy
  • oesophagogastrectomy

Partial gastrectomy

Duringa partial gastrectomy, the surgeon makes a cutin 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's arisk the cancermay havespread to the nodes.

Your surgeon then stitchesthe upper part of your stomach to your small intestine.

Total gastrectomy

During total gastrectomy, your surgeon makes acut in yourabdomen 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.

Sleeve gastrectomy

During sleeve gastrectomy,the surgeon makes acut in your abdomen before removing the left side of your stomach. This can reduce your stomach's volume by up to 75%, and 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

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

The lower part of your stomach ispulled 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 largecut 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 havekeyhole surgeryusually recoverquicker 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 ratesafter keyhole surgery are similar tothose for open gastrectomies.

Keyhole surgeryis an advanced surgical technique requiring specialised training and equipment. Theoperation may take longer if it's carried out using keyhole surgery.

Open gastrectomies are usually more effective in treating advanced stomach cancer compared with keyhole surgery. This is because it's usuallyeasier 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.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 28 Nov 2016