Surgery

Keyhole Surgical Removal of Part or All of the Stomach

Why It’s Done (Indications)

Mainly performed to treat stomach cancer, severe non-healing stomach ulcers, or non-cancerous stomach tumours.

How to Prepare (Preparations)

• Fasting (no food or drink) for 6 hours before surgery.
• Pause blood-thinning medications as instructed by your doctor.
• Nutritional optimization, including high-protein supplements prior to the operation.

What Happens (Procedural Details)

• Anaesthesia & Port Placement: Performed under general anaesthesia. The surgeon places 5 to 6 small keyhole incisions across the upper abdomen to insert the camera and delicate laparoscopic instruments.
• Dissection & Lymph Node Clearance: The surgeon carefully separates the stomach from its surrounding fatty attachments, spleen, and pancreas. The blood vessels supplying the target area of the stomach are clipped and divided. Surrounding lymph nodes are systematically removed for biopsy.
• Dividing the Stomach:
  • Subtotal Gastrectomy: The upper portion of the stomach is preserved, and only the lower diseased segment is cut across using a linear surgical stapler.
  • Total Gastrectomy: The entire stomach is cut away from the esophagus above and the small intestine below.
• Reconstruction: The surgeon reconnects the remaining stomach (or the esophagus, in a total gastrectomy) directly to the small intestine using surgical stapling devices, creating a new pathway for food.
• Specimen Extraction & Drain: The removed stomach tissue is pulled out through a slightly enlarged incision (usually near the belly button). A small plastic drainage tube may be left in the abdomen to monitor for internal bleeding or leaks over the first few days before closing.
   

Recovery (Postoperative Care)

• Hospital stay lasts approximately 5 to 10 days.
• You will start with small sips of water, gradually progressing to pureed and soft meals.
• You will learn to eat smaller, more frequent meals to adapt to reduced stomach capacity.
   

Risks (Potential Complications)

• Leakage at the surgical joins (anastomotic leak).
• Vitamin deficiencies (especially Vitamin B12, requiring long-term supplementation).
• "Dumping syndrome" (rapid stomach emptying causing nausea, dizziness, and diarrhea after eating).