Indications for Surgery:
• Stomach cancer.
• Benign tumors and cysts of the stomach.
• Disorders related to stomach motility.
What to Expect?
Before the surgery, the doctor may perform some of the following procedures or all of them:
Physical examination, blood and urine tests, possible imaging: chest X-ray, abdominal ultrasound, computed tomography (CT) scan of the chest and abdomen, MRI, upper gastrointestinal endoscopy.
How to Prepare for the Surgery?
Inform your doctor about any regular medications. You may be asked to stop taking certain medications a week before the surgery, such as:
- Anti-inflammatory drugs (e.g., aspirin).
- Blood thinners, such as Plavix or Coumadin.
- Fasting before the surgery.
- You may receive a catheter and prophylactic antibiotics before the surgery.
Anesthesia
The surgery is performed under general anesthesia. This will prevent any pain, and you will remain asleep throughout the procedure.
During the anesthesia, you will breathe through a tube inserted into your airway.
The Course of Surgery:
Depending on the segment of the stomach that needs to be removed, the doctor will make an incision in the neck, chest, or abdomen using one of the following methods:
• Open surgery - a relatively large incision, and the affected stomach part is removed through this incision.
• Laparoscopic surgery - several small incisions, inserting a camera and other instruments through these incisions. The surgery is viewed on a screen showing the surgical image.
The resected stomach part is usually replaced by the intestine, and connections are made between the remaining stomach and the intestine.
Sometimes, lymph nodes near the stomach may need to be removed.
The surgery lasts about six hours.
How Much Pain to Expect?
Despite pain relief, some discomfort is expected after the surgery.
Painkillers will be given as needed and in consultation with the pain service.
The average hospital stay is about one to two weeks if there are no complications.
Postoperative Treatment:
- Special stockings will be used to prevent blood clots in the legs.
- The physiotherapy team will guide and assist you in performing appropriate breathing exercises.
- It is recommended to get out of bed several times a day, as walking accelerates the healing process and reduces the risk of complications, such as pneumonia.
- During the first week, you will not be allowed to eat or drink through the mouth. Nutrition will be provided through a feeding tube.
- During the first one to two weeks after the surgery, you will undergo a swallowing study to check for leakage from the connection.
- If the swallowing test is normal, you will gradually resume oral feeding, starting with clear fluids, then a soft diet, and finally a solid diet.
- After about a month, you will return to your regular diet.
- The stomach will be smaller, so smaller meals will be necessary.
Possible Complications of Surgery:
Bleeding, infection, sore throat, anesthesia-related side effects, leakage from the connection, heart attack.
Factors that may increase the risk of complications include:
Heart or lung diseases, advanced age, obesity, smoking, diabetes, excessive alcohol consumption.
After being discharged from the hospital, you should contact your doctor if you experience any of the following:
Signs of inflammation, including fever and chills, redness, swelling, increasing pain, discharge from the incision site, nausea and/or vomiting, pain that cannot be controlled with the given medication, pain, burning, urgency, or frequency during urination, cough, shortness of breath, chest pain, constipation or diarrhea, pain and/or swelling in the feet, ankles, or legs.