Gastrectomy – Everything You Need to Know

Gastrectomy, is a surgical procedure that involves the removal of a part or all of the stomach. This procedure is used to treat stomach cancer, esophageal cancer, obesity, stomach ulcers and non-cancerous tumors. 

When is this procedure performed?

Weight loss is achieved through diet control and exercises, however, certain morbidly obese find it challenging to lose weight using traditional methods. For such patients, sleeve gastrectomy offers obese patients the option to staple (or remove) certain parts of their stomach, and as a result, drastically reduce the amount of food the stomach can digest. 

Along with obesity, patients who have been diagnosed with stomach or esophageal cancer are also eligible to undergo this procedure. 

What are the types of gastrectomy?

Depending on the severity of the symptoms, the surgeon would recommend partial or complete removal of the stomach. This can be achieved through the following types of gastrectomy:

1. Partial gastrectomy – In this type of gastrectomy, the lower portion of the stomach is surgically removed.
2. Complete gastrectomy – This type of gastrectomy involves the removal of the entire stomach. 
3. Oesophagogastrectomy – For this type of gastrectomy, the upper portion, along with the esophagus (the tube connecting the throat to the stomach is removed. 
4. Sleeve gastrectomy – For this type of gastrectomy, the left portion of the stomach is surgically removed and the remaining part of the stomach is formed into a tube-like structure, creating a bottleneck effect to suppress appetite and overall stomach capacity. 

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How is gastrectomy performed?

Gastrectomy is performed using the following techniques:

1. Open surgery – This procedure involves opening up the abdomen using a large, single incision, and accessing the stomach by pulling back the abdomen skin and muscle. 
2. Laparoscopic surgery – Also known as keyhole surgery, this procedure is a type of minimally invasive surgery that involves the use of small incisions, through which specialized tools are inserted and used for removing portions, or all of the stomach. Today, most surgeons prefer using this technique due to the low number of complications associated with the procedure.

How does one prepare for a gastrectomy?

Before the start of the procedure, the doctor will run a physical examination and also review the patient’s history of any existing conditions, such as diabetes. The doctor will also review any existing medications and check if they can cause any complication during the procedure. 

What are the benefits of gastrectomy?

Gastrectomy is used to treat weight-related disorders, such as:

• Obesity (Body Mass Index is higher than 40)
• Heart disease
• High blood pressure
• High cholesterol
• Obstructive sleep apnea
• Type 2 diabetes

Through this procedure, patients suffering from obesity can get a boost in starting their weight loss journey, and begin adapting a healthy, active lifestyle, since many morbidly obese patients find it hard to start and continue with any weight loss regimen. 

Other benefits associated with sleeve gastrectomy are:

• Affordable option for weight loss
• High rates of success and almost no mortality
• Patients report reduced appetite
• Lack of any major anatomical disturbance

What are the risks involved with sleeve gastrectomy?

While sleeve gastrectomy has a high success rate and poses minimal complications, there are certain risks associated with this procedure: 

• Infections in the chest and incision wound
• Internal bleeding
• Leakage at the incision sites
• Diarrhea
• Acid reflux

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What to expect

Before the surgery

Before the start of the procedure, patients will be required to discuss existing medications and any specific guideline that is required to fully prepare the patient. On the day of the surgery, patients are administered general anesthesia for the entirety of the procedure. 

During the procedure

For a sleeve gastrectomy procedure, the surgeon will start by making small incisions in the upper abdomen. Through these incisions, the surgeon would insert surgical instruments and proceed to staple the stomach to create a narrow sleeve, and remove the larger portion of the stomach. This procedure usually takes one to two hours. 

After the procedure

Once the procedure is completed, the patient is kept under observation and the recovery is monitored. On discharge, patients are asked to follow a liquid diet that’s free from sugar and noncarbonated. After a week, patients are then asked to consume a semi-solid diet that’s easy to swallow. After 3 to 4 weeks, the patients are allowed to consume regular food. Vitamin supplements are also prescribed to ensure patients get the right nutrition.

What are the lifestyle changes required for patients’ post-surgery?

Patients who have completed sleeve gastrectomy are advised to make the following changes to their existing lifestyle – 

• Eat smaller meals instead of large ones.
• Increase intake of foods rich in vitamins C and D, iron and calcium
• Avoid consuming foods high in fiber

Conclusion

Sleeve gastrectomy is a widely administered surgical procedure to treat weight-related disorders, especially for patients who face trouble losing weight through traditional methods. By removing parts or the entire stomach, patients are no longer able to consume high quantities of food, and as a result, they can achieve weight loss. 

Once the procedure is completed, patients are expected to follow a fixed diet and make lifestyle changes to ensure the body adjusts to the reduced working of the stomach. 

FAQs

How long does the surgery take?

Sleeve gastrectomy procedures usually take 1 to 2 hours to complete.

How much of my stomach will be removed?

Depending on the extent of symptoms, surgeons will recommend either certain parts of the stomach, or the full stomach.

How much and how fast can I expect a weight loss?

Once the sleeve gastrectomy procedure is completed, most patients report losing 50% of weight within 24 months. 

Can your stomach grow back after removal?

No, but the existing parts of the stomach can stretch to digest any extra portions of food.

Can you drink alcohol after a gastrectomy?

Patients are advised to avoid alcohol for up to 6 months once the procedure is completed.