Stomach Cancer Surgery
Treatment of Gastric Cancer
Surgery is part of the treatment for different stages of stomach cancer, whenever it can be done. If a patient is physically fit, surgery often, along with other treatments, offers the only real chance of cure. Surgery can be performed to remove the tumor and part or all of the stomach and some nearby lymph nodes, depending on the type and stage of the disease. The surgeon will try to preserve as much of the stomach as possible without disease. Sometimes other organs also need to be removed.
Therefore, surgery can be divided into Partial Gastrectomy and Total Gastrectomy. Lymphadenectomy (removal of lymph nodes or nodes) is usually performed near the stomach.
Palliative Surgery
Even when the cancer is at an advanced stage to be completely removed, surgery is indicated as it prevents bleeding from the tumor or obstruction of the stomach by tumor growth. This type of surgery is called palliative surgery, that is, it relieves symptoms but is not expected to cure the disease.
Minimally Invasive Surgery
Most subtotal and total gastrectomies are still performed through a large incision in the abdomen. But currently we have performed an increasing number of Minimally Invasive Surgeries, whether laparoscopic or robotic surgery.
LEARN MORE ABOUT ROBOTIC SURGERY
Partial gastrectomy with lymphadenectomy - Resection of part of the stomach together with the lymph nodes
This surgery is often indicated if the cancer is located in the lower portion of the stomach. The procedure involves removing only part of the stomach, or the first part of the small intestine (duodenum). The remaining part of the stomach is then reconnected. The omentum, the layer of fatty tissue that lines the stomach and intestines, is removed, as are the adjacent lymph nodes, and possibly the spleen and, if applicable, parts of other nearby organs. Feeding becomes easier if only a part of the stomach is removed rather than the entire organ. In some special circumstances, only the upper part of the esophagus may be removed to remove cancers that are only in the upper part of the stomach.
Total gastrectomy with lymphadenectomy - Total stomach resection with lymphadenectomy
This surgery is performed when the cancer has spread throughout the stomach. It is also indicated if the disease is located in the upper part of the stomach, close to the esophagus. In total gastrectomy, the entire stomach, nearby lymph nodes and the omentum are removed, and may also include the removal of the spleen and parts of the esophagus, intestine, pancreas and other adjacent organs. The end of the esophagus is then connected to a part of the small intestine, creating a space for food to be stored before it descends into the intestinal tract. Patients who have had their stomach removed can only eat small amounts of food at a time, so they should eat several times a day.
Lymphadenectomy - Resection of part of the stomach along with the lymph nodes
In any type of total or partial (subtotal) gastrectomy, nearby lymph nodes are removed. Lymph node removal is a very important part of the surgery. The success of surgery is directly related to the number and way in which lymph nodes are removed.
See below the video of a Robotic Total Gastrectomy: Total gastrectomy with D2 lymphadenectomy for treatment of gastric cancer by robotic surgery.