Gastrectomy (resection of stomach)

The condition

The patient may have a tumor of the stomach which needs to be removed by surgery. The precise location of the tumor will determine how much (all or some) of the stomach will need to be removed. The doctors should discuss this with the patient.

Symptoms

• Nausea, vomiting
• Abdominal pain
• Weight loss
• Weakness
• Anemia

The procedure

This operation can be done either open or laparoscopic. For the open surgery a large incision is required, whereas for the laparoscopic the surgeon will make about 4-6 small incisions in the abdomen. A port (nozzle) is inserted into one of the slits, and carbon dioxide gas inflates the abdomen. This process allows the surgeon to see inside of the abdomen more easily. A laparoscope is inserted through another port. The laparoscope looks like a telescope with a light and camera on the end so the surgeon can see inside the abdomen. Surgical instruments are placed in the other small openings and used to remove the portion of the stomach that contains the tumor. The stomach specimen is removed in a plastic bag from the abdomen by enlarging one of the small incisions on the abdomen. After all or some of stomach has been removed, the small intestine will be connected to the esophagus or remnant of the stomach, so that the patient will be able to eat again. This connection is usually done with surgical staplers. After this has been accomplished, the carbon dioxide is released out of the abdomen through the slits, and then these sites are closed with sutures or staples, or covered with glue-like bandage and steri-strips.

Nonsurgical Treatment

Chemotherapy for stomach tumors is generally not effective, so surgery usually is the best option for a tumor that is localized to the stomach. If the tumor has spread beyond the stomach, then the doctor should discuss the treatment options with the patient.

Risks

• Infection of the skin at the incision site
• Leakage of the connection between the stomach and small bowel
• Collection of pus inside the abdomen (intra-abdominal abscess)
• Postoperative ileus (the intestines slow down/stop working for several days)
• Small bowel obstruction (kinking of the small bowel, causing blockage)
• Pneumonia
• Bleeding

Medical negligence

The above mentioned risks and complications are known to happen with gastrectomy (resection of stomach) and such complications do not necessarily constitute deviation from the medical standard of care. The following examples however may be considered as medical negligence.

• Disruption of the anastomosis (connection) and failure to diagnose and treat in a timely fashion.