Gastrectomy

Overview

A gastrectomy is a surgical procedure to remove all or part of the stomach. It is performed to treat conditions such as stomach cancer, severe peptic ulcers, and non-cancerous growths. The surgery can be done using traditional open surgery or minimally invasive techniques like laparoscopic or robotic-assisted surgery.

About Gastrectomy

A gastrectomy is a surgical procedure involving the removal of all or part of the stomach. This operation is commonly performed to treat various conditions that affect the stomach, such as stomach cancer, severe peptic ulcers, and non-cancerous growths like polyps. In some cases, gastrectomy is also used as a treatment for obesity. The procedure can be performed using either traditional open surgery or minimally invasive techniques such as laparoscopic or robotic-assisted surgery.

What is Gastrectomy?

A gastrectomy is a surgical procedure that involves the removal of all or part of the stomach. This operation is commonly performed to treat various serious medical conditions affecting the stomach, such as stomach cancer, severe peptic ulcers, non-cancerous growths like polyps, and certain conditions related to obesity. The procedure can be performed using either traditional open surgery or minimally invasive techniques, such as laparoscopic or robotic-assisted surgery, which offer faster recovery times and smaller scars.

There are different types of gastrectomy procedures, depending on the extent of the stomach that needs to be removed. A total gastrectomy involves the complete removal of the stomach. In this procedure, the surgeon connects the esophagus directly to the small intestine, allowing food to pass through the digestive system. This type of surgery is often performed for advanced stomach cancer where the disease has spread extensively throughout the stomach. 

A partial gastrectomy (or subtotal gastrectomy) involves removing a portion of the stomach, usually the lower part, while preserving the rest of the organ. This procedure is typically performed for conditions like peptic ulcers or localized tumors. After removing the affected part of the stomach, the remaining section is reconnected to the small intestine to ensure normal digestive function.

Another common type of gastrectomy is the sleeve gastrectomy, often used as a weight-loss surgery for individuals with obesity. In this procedure, a large portion of the stomach is removed, leaving behind a narrow, tube-shaped section resembling a sleeve. The reduced stomach size restricts food intake and promotes weight loss by making the patient feel full more quickly.

The decision to undergo a gastrectomy and the specific type of procedure depend on the patient's medical condition, overall health, and the surgeon's expertise. Preoperative preparation is essential and may include dietary modifications, fasting, and a thorough evaluation of the patient's medical history and current health status. Patients are also advised to discuss potential risks and benefits with their healthcare provider to make an informed decision.

Following a gastrectomy, patients need to adhere to specific postoperative care instructions to ensure proper healing and adjustment to changes in their digestive system. This may include a modified diet, gradual reintroduction of solid foods, and regular follow-up appointments to monitor recovery. Nutritional supplements and medications may also be prescribed to aid digestion and prevent complications.

What does Gastrectomy treat?

A gastrectomy is a surgical procedure that involves removing all or part of the stomach to treat a variety of serious medical conditions affecting this crucial organ. The procedure is often essential for alleviating symptoms, preventing complications, and improving the patient's quality of life.

• Stomach Cancer: One of the most common reasons for a gastrectomy is the treatment of stomach cancer, also known as gastric cancer. This type of cancer can develop in any part of the stomach and may spread to other organs if not treated promptly. Depending on the stage and location of the cancer, a total gastrectomy (removal of the entire stomach) or a partial gastrectomy (removal of the affected portion) may be performed. The goal of the surgery is to remove the cancerous tissue and prevent the spread of the disease.

• Severe Peptic Ulcers: Peptic ulcers are open sores that develop on the inner lining of the stomach or the upper part of the small intestine. While most peptic ulcers can be treated with medications and lifestyle changes, some severe cases may require surgical intervention. A gastrectomy may be necessary when ulcers are resistant to treatment, recurrent, or complicated by bleeding, perforation, or obstruction. By removing the affected portion of the stomach, the surgery helps to alleviate symptoms and prevent further complications.

• Non-Cancerous Growths: Gastrectomy is also used to treat non-cancerous growths, such as gastric polyps and benign tumors, that have the potential to cause significant symptoms or transform into malignant tumors. Removing these growths can prevent future complications and improve the patient's overall health.

• Obesity: In certain cases, gastrectomy is performed as a weight-loss surgery for individuals with severe obesity who have not achieved significant results through diet, exercise, or other non-surgical methods. Sleeve gastrectomy, a type of bariatric surgery, involves removing a large portion of the stomach, leaving behind a narrow, tube-shaped section. This reduction in stomach size restricts food intake and promotes weight loss by making the patient feel full more quickly. The surgery can help alleviate obesity-related health issues such as diabetes, hypertension, and sleep apnea.

• Familial Gastric Polyposis: This rare genetic condition causes the development of numerous polyps in the stomach, which have a high potential for becoming cancerous. Prophylactic (preventative) gastrectomy may be recommended to remove the stomach and prevent the development of gastric cancer in individuals with this condition.

How to prepare for Gastrectomy?

Preparing for a gastrectomy, a surgical procedure to remove all or part of the stomach, is essential to ensure the patient's safety and the success of the operation. Proper preparation involves medical evaluations, preoperative instructions, and emotional readiness, all of which contribute to a smoother surgical experience and recovery.

• Medical Evaluations: Before the surgery, patients undergo a thorough medical evaluation, including a detailed medical history, physical examination, and various diagnostic tests. Blood tests, imaging studies such as CT scans or MRIs, and endoscopy may be performed to assess the extent of the disease and the overall health of the patient. These evaluations help the surgical team plan the procedure and identify any potential risks or complications.

• Preoperative Instructions: Patients receive specific instructions from their healthcare provider to follow in the days leading up to the surgery. One of the key instructions is fasting, which typically requires patients to refrain from eating or drinking for at least six to eight hours before the procedure. This is crucial to reduce the risk of aspiration (inhaling stomach contents into the lungs) during anesthesia. Patients may also be advised to stop taking certain medications, such as blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), and supplements, to minimize the risk of bleeding. It is essential for patients to inform their healthcare provider about all medications and supplements they are taking, as well as any allergies or medical conditions.

• Bowel Preparation: Depending on the type of gastrectomy and the surgeon's preference, patients may need to undergo bowel preparation to cleanse the digestive tract. This typically involves a special diet, laxatives, and sometimes enemas, to ensure the stomach and intestines are empty before the surgery. A clean digestive tract reduces the risk of infection and allows the surgeon to have a clearer view of the surgical site.

• Hospital Arrangements: Patients are usually given instructions on what to bring to the hospital, such as identification, insurance information, and personal items like comfortable clothing and toiletries. It is also important to arrange for transportation to and from the hospital, as patients will not be able to drive themselves after the procedure.

• Emotional Readiness: Preparing emotionally for a gastrectomy is equally important. Patients may feel anxious or stressed about the upcoming surgery, and it is essential to address these feelings. Talking to the healthcare provider, asking questions, and discussing any concerns can help alleviate anxiety. Support from family and friends can also provide emotional comfort. Additionally, patients may benefit from relaxation techniques, such as deep breathing exercises, meditation, or listening to calming music.

• Preoperative Education: Many hospitals offer preoperative education classes or materials to help patients understand what to expect before, during, and after the surgery. These resources provide valuable information on the surgical process, pain management, postoperative care, and recovery timeline.

Gastrectomy Process

What happens after Gastrectomy?

After a gastrectomy, a surgical procedure involving the removal of all or part of the stomach, patients undergo several critical phases in their recovery to ensure proper healing and adjustment to changes in their digestive system. 

• Immediate Postoperative Phase: Immediately following the surgery, patients are moved to the recovery room where they are closely monitored as they awaken from anesthesia. Vital signs, including heart rate, blood pressure, and oxygen levels, are continuously checked to ensure stability. Pain management is a priority, and patients receive medications to alleviate discomfort and prevent nausea. Patients who undergo minimally invasive procedures like laparoscopic gastrectomy typically experience less postoperative pain and faster recovery compared to those who have open surgery.

• Hospital Stay: Depending on the type and extent of the surgery, patients may stay in the hospital for several days. During this time, healthcare providers monitor the patient's recovery, manage pain, and prevent complications. Patients are encouraged to begin light activities, such as walking, to promote circulation and prevent blood clots. A gradual reintroduction of clear liquids is usually the first dietary step, followed by a slow transition to more substantial foods as tolerated.

• Nutritional Adjustments: Since the stomach's capacity is significantly reduced, patients must adapt to new eating habits. Small, frequent meals become essential to avoid overloading the digestive system. Initially, a liquid or soft diet is recommended, gradually transitioning to more solid foods. Nutritional supplements and vitamin injections may be necessary to prevent deficiencies, particularly for patients who have undergone a total gastrectomy. Common supplements include vitamin B12, iron, calcium, and vitamin D, as the body's ability to absorb these nutrients can be compromised.

• Monitoring and Follow-Up: Regular follow-up appointments are crucial to monitor the patient's progress and address any complications or concerns. During these visits, healthcare providers assess the surgical site for signs of infection, ensure proper wound healing, and evaluate the patient's overall health. Blood tests and imaging studies may be conducted to check for nutritional deficiencies, monitor for recurrence of disease, and ensure that the digestive system is functioning correctly.

• Potential Complications: Patients should be aware of potential complications such as infections, blood clots, anastomotic leaks (where the surgical connection between the esophagus and small intestine leaks), and nutritional deficiencies. Early detection and prompt medical intervention are essential to address these issues effectively. Symptoms like persistent pain, fever, redness or swelling at the incision site, and unusual changes in bowel habits should be reported to the healthcare provider immediately.

• Long-Term Adaptations: Over time, patients typically adapt to their new digestive anatomy and develop a routine that suits their needs. Regular monitoring and adjustments to the diet and supplements help maintain optimal health. Patients may need to avoid certain foods that cause discomfort or are difficult to digest. Support from dietitians, nutritionists, and support groups can be invaluable in navigating these long-term changes.

Gastrectomy risks

While a gastrectomy, the surgical removal of all or part of the stomach, can be a crucial and life-saving procedure for treating various serious medical conditions, it does carry certain risks and potential complications, as with any major surgery. Understanding these risks is essential for patients to make informed decisions and to prepare adequately for the surgery and postoperative care.

• Infection: One of the primary risks associated with a gastrectomy is infection. This can occur at the incision site or within the abdominal cavity. Despite strict aseptic techniques and the use of prophylactic antibiotics, bacteria can still enter the surgical site, leading to redness, swelling, pain, and potentially the formation of an abscess. Severe infections may require additional treatment, such as antibiotic therapy or drainage.

• Bleeding and Hematoma: Bleeding is a common risk in any surgical procedure. While most cases involve minor bleeding that is easily controlled, excessive bleeding or the formation of a hematoma (a collection of blood outside the blood vessels) can occur. This may require further intervention to manage and resolve the issue.

• Damage to Nearby Organs: The stomach is located near several vital structures, including the small intestine, pancreas, spleen, and liver. During the surgery, there is a risk of inadvertently damaging these nearby organs, which could lead to complications such as bowel perforation, pancreatic injuries, or damage to the spleen. If this occurs, additional surgical procedures may be needed to repair the damage.

• Anastomotic Leak: In cases where part of the stomach is removed, the remaining sections are reconnected to the small intestine through a procedure called anastomosis. One of the most serious complications of a gastrectomy is an anastomotic leak, where the connection between the stomach and small intestine fails to heal properly, allowing stomach contents to leak into the abdominal cavity. This can lead to peritonitis (infection of the abdominal lining) and sepsis, a life-threatening condition. Prompt medical attention and surgical intervention are required to address this complication.

• Anesthesia-Related Risks: General anesthesia is used during a gastrectomy to ensure the patient is unconscious and free from pain. However, anesthesia carries its own set of risks, including allergic reactions, respiratory complications, and adverse effects on the cardiovascular system. A thorough preoperative evaluation and careful anesthetic management are essential to minimize these risks.

• Postoperative Complications: After the surgery, patients may experience postoperative complications such as ileus (a temporary slowing or stopping of intestinal function), wound dehiscence (reopening of the surgical incision), or deep vein thrombosis (blood clot formation in the deep veins, usually in the legs). These complications require prompt medical attention and appropriate treatment.

• Nutritional Deficiencies: Since the stomach plays a critical role in the digestion and absorption of nutrients, removing part or all of the stomach can lead to nutritional deficiencies. Patients may need to take vitamin and mineral supplements, such as vitamin B12, iron, calcium, and vitamin D, to prevent deficiencies and support overall health.

• Dumping Syndrome: A potential risk specific to gastrectomy is dumping syndrome, a condition where food moves too quickly from the stomach to the small intestine. This can cause symptoms such as nausea, vomiting, diarrhea, dizziness, and rapid heartbeat. Dietary modifications, such as eating smaller, more frequent meals and avoiding high-sugar foods, can help manage this condition.

Gastrectomy benefits

A gastrectomy, which involves the surgical removal of all or part of the stomach, offers significant benefits for individuals suffering from various serious medical conditions affecting this vital organ. The primary goal of this procedure is to alleviate symptoms, prevent complications, and improve the patient's quality of life. 

• Treating Stomach Cancer: One of the most critical benefits of gastrectomy is its role in treating stomach cancer. By surgically removing the cancerous tissue, either through a partial or total gastrectomy, the procedure can prevent the spread of cancer to other parts of the body, thereby increasing the patient's chances of survival and long-term remission. Gastrectomy is often a crucial part of the treatment plan for patients with early-stage and advanced gastric cancer.

• Alleviating Severe Peptic Ulcers: For patients with severe peptic ulcers that do not respond to medical treatment or are complicated by bleeding, perforation, or obstruction, a gastrectomy can provide much-needed relief. By removing the affected portion of the stomach, the surgery helps to eliminate the source of the ulcers and prevent further complications, leading to a significant improvement in the patient's quality of life.

• Managing Non-Cancerous Growths: Gastrectomy is also beneficial in treating non-cancerous growths, such as gastric polyps and benign tumors, that have the potential to cause significant symptoms or transform into malignant tumors. Removing these growths can prevent future complications and improve the patient's overall health and well-being.

• Addressing Obesity: In certain cases, gastrectomy is performed as a weight-loss surgery for individuals with severe obesity who have not achieved significant results through diet, exercise, or other non-surgical methods. Sleeve gastrectomy, a type of bariatric surgery, involves removing a large portion of the stomach, leaving behind a narrow, tube-shaped section. This reduction in stomach size restricts food intake and promotes weight loss by making the patient feel full more quickly. The surgery can help alleviate obesity-related health issues such as diabetes, hypertension, and sleep apnea, thereby enhancing the patient's overall health and quality of life.

• Preventing Familial Gastric Polyposis: This rare genetic condition causes the development of numerous polyps in the stomach, which have a high potential for becoming cancerous. Prophylactic (preventative) gastrectomy may be recommended to remove the stomach and prevent the development of gastric cancer in individuals with this condition, thereby significantly reducing their cancer risk and improving life expectancy.

• Enhancing Quality of Life: For patients with chronic and debilitating stomach conditions, a gastrectomy can drastically improve their quality of life. The surgery can alleviate chronic pain, reduce the frequency and severity of gastrointestinal symptoms, and restore the ability to engage in daily activities without constant discomfort. Patients who have struggled with dietary restrictions, fatigue, and emotional distress related to their condition often find significant relief and an improved sense of well-being after the procedure.

Gastrectomy recovery

Recovery from a gastrectomy, a surgical procedure to remove all or part of the stomach, is a multifaceted process that requires careful attention and adherence to medical advice to ensure proper healing and adjustment to changes in the digestive system. The recovery process can vary depending on the type of gastrectomy performed—whether it is a partial gastrectomy, total gastrectomy, or sleeve gastrectomy—and individual patient factors such as overall health and age.

• Immediate Postoperative Phase: Immediately after the surgery, patients are taken to the recovery room, where they are closely monitored as they wake up from general anesthesia. Vital signs, such as heart rate, blood pressure, and oxygen levels, are continuously checked to ensure the patient's stability. Pain management is a priority, and medications are administered to alleviate discomfort and prevent nausea. Patients who undergo minimally invasive procedures like laparoscopic gastrectomy often experience less postoperative pain and faster recovery compared to those who have open surgery.

• Hospital Stay: Patients typically stay in the hospital for a few days following the surgery, depending on the extent of the procedure and their overall condition. During this time, healthcare providers monitor the patient's recovery, manage pain, and prevent complications. Patients are encouraged to begin light activities, such as walking, to promote circulation, prevent blood clots, and aid in the recovery process. Initially, patients may be restricted to a clear liquid diet, gradually progressing to more substantial foods as tolerated.

• Nutritional Adjustments: Since the stomach's capacity is significantly reduced, patients must adapt to new eating habits. Small, frequent meals become essential to avoid overloading the digestive system. Initially, a liquid or soft diet is recommended, gradually transitioning to more solid foods. Nutritional supplements and vitamin injections may be necessary to prevent deficiencies, particularly for patients who have undergone a total gastrectomy. Common supplements include vitamin B12, iron, calcium, and vitamin D, as the body's ability to absorb these nutrients can be compromised.

• Monitoring and Follow-Up: Regular follow-up appointments are crucial to monitor the patient's progress and address any complications or concerns. During these visits, healthcare providers assess the surgical site for signs of infection, ensure proper wound healing, and evaluate the patient's overall health. Blood tests and imaging studies may be conducted to check for nutritional deficiencies, monitor for recurrence of disease, and ensure that the digestive system is functioning correctly.

• Potential Complications: Patients should be aware of potential complications such as infections, blood clots, anastomotic leaks (where the surgical connection between the stomach and small intestine leaks), and nutritional deficiencies. Early detection and prompt medical intervention are essential to address these issues effectively. Symptoms like persistent pain, fever, redness or swelling at the incision site, and unusual changes in bowel habits should be reported to the healthcare provider immediately.

• Long-Term Adaptations: Over time, patients typically adapt to their new digestive anatomy and develop a routine that suits their needs. Regular monitoring and adjustments to the diet and supplements help maintain optimal health. Patients may need to avoid certain foods that cause discomfort or are difficult to digest. Support from dietitians, nutritionists, and support groups can be invaluable in navigating these long-term changes.

Gastrectomy in Iran

Equipped hospitals, and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who need Gastrectomy.

Gastrectomy cost in Iran

The cost of a gastrectomy in Iran can vary depending on several factors, including the type of procedure, the hospital or clinic chosen, and the specific services included in the package. Generally, the cost of a gastrectomy in Iran is significantly lower compared to many Western countries, making it an attractive option for medical tourism. The cost of Gastrectomy in Iran ranges around 4,200-5,300 USD.

Iranian hospitals and clinics are equipped with modern medical technology and staffed by highly skilled surgeons who have extensive experience in performing gastrectomy procedures. The country's healthcare system is known for its high standards of care and affordability, making it a popular destination for patients seeking cost-effective surgical options.

In addition to the lower costs, patients who choose to undergo a gastrectomy in Iran can benefit from shorter waiting times and personalized care from experienced medical professionals. The country's rich cultural heritage and hospitable people also make it an appealing destination for medical tourists.