Gastric Surgery

Gastric surgery addresses conditions like stomach cancer, severe ulcers, tumors (GISTs), obstructions, refractory severe GERD, and gastroparesis, often using procedures like partial/total gastrectomy or wedge resections to relieve symptoms or remove disease. Key indications involve malignancy, functional disorders like severe reflux or slow emptying (gastroparesis), and physical blockages.

Common Indications:

• Malignancy (Cancer): Stomach cancer, gastrointestinal stromal tumors (GISTs), or tumors near the stomach requiring removal (partial/total gastrectomy).
• Severe Peptic Ulcers: When ulcers are uncontrolled by medication, cause severe bleeding (hematemesis), or lead to obstructions.
• Gastric Outlet Obstruction: Blockage preventing food from passing into the small intestine, from causes like tumors, strictures, or adhesions.
• Severe Gastroesophageal Reflux Disease (GERD): Refractory GERD, especially when combined with other issues like large hiatal hernias, may lead to procedures like fundoplication.
• Gastroparesis: Severe, non-responsive slow stomach emptying, often related to diabetes, leading to vomiting and poor nutrition.
• Non-Malignant Tumors/Polyps: Large, problematic polyps or benign tumors in the stomach.
• Severe Dysphagia/Volvulus: Difficulty swallowing or twisting of the stomach (gastric volvulus) causing obstruction.
• Morbid Obesity Complications: Complications after bariatric surgery may require surgery of the stomach.

Types of Procedures Used:

• Partial or total gastrectomy: Removal of part of or all the stomach, common for cancer or ulcers.
• Wedge resection: a 'wedge' or small portion is removed, may be performed for benign tumors, is less invasive than a formal partial or total gastrectomy.
• Roux-en-Y gastric bypass: Sometimes used for refractory GERD or gastroparesis.
• Laparoscopic assisted PEG insertion: patients who cannot undergo a PEG tube due to anatomical reasons or prior surgeries benefit from a laparoscopic assisted PEG insertion, thus avoiding a potential open procedure and leading to faster recovery.