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
During a partial gastrectomy, the surgeon makes a cut in 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 a risk the cancer may have spread to the nodes.
Your surgeon then stitches the upper part of your stomach to your small intestine.
During total gastrectomy, your surgeon makes a cut in 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.
During sleeve gastrectomy, the surgeon makes a cut 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.
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 quicker 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 requiring specialised training and equipment. The operation 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 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.