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Stomach Surgery (Gastrectomy)
A gastrectomy is surgery to remove part or all of the stomach, tailored to the tumor location and stage to ensure safe cancer control.
What is a gastrectomy?
A gastrectomy is a surgical procedure to remove part or all of the stomach. The specific operation depends on the tumor location, its stage, and your overall health. During the procedure, the surgeon may also remove nearby lymph nodes to help stage the cancer and guide further treatment. After the stomach is removed, the digestive tract is reconstructed to allow you to swallow and digest food.
Types of Stomach Surgery
The choice of surgery follows a careful review of your tests and health. A subtotal gastrectomy removes only the cancerous part, keeping the rest of the stomach when safe. A total gastrectomy removes the entire stomach and requires reconstruction, typically used when cancer involves most of the organ. Minimally invasive approaches using small incisions and robotic tools may be used to reduce pain and speed recovery when appropriate.
The Surgical Process
The surgical plan is built around your specific diagnosis and overall health, coordinating with oncology and nutrition experts.
A thorough review of biopsy results, imaging, and lab work helps confirm the diagnosis and determine if the tumor is removable.
Some patients receive chemotherapy or other therapies before surgery to shrink the cancer and improve outcomes.
The surgeon removes the affected portion of the stomach and nearby lymph nodes using either an open or minimally invasive approach.
The digestive tract is reconnected, such as attaching the esophagus to the small intestine, to restore the ability to eat.
Post-surgery care focuses on pain control, advancing your diet slowly, and ongoing monitoring by your medical team.
Preparing for Surgery
Preparation involves reviewing your medical history, checking heart and lung health, and planning for nutrition optimization.
Required before surgery
• Upper endoscopy with biopsy to confirm diagnosis.
• CT scans of the chest, abdomen, and pelvis to check for spread.
• Nutrition evaluation for patients with weight loss.
Sometimes also ordered
• Endoscopic ultrasound, PET, or MRI scans.
• Staging laparoscopy to further evaluate the tumor.
• Heart and lung health screenings.
Surgical Candidates
Surgery is considered when the tumor is removable and the patient is healthy enough for a major operation.
Likely good candidates
• Patients with removable stomach tumors.
• Individuals healthy enough for major surgery.
• Those who have completed recommended preoperative therapy.
May need further evaluation
• Patients with cancer that has spread too extensively for removal.
• Individuals with severe underlying health conditions that make surgery unsafe.
Not sure if you qualify?
Dr. Dunn reviews every case personally. Book a consultation and he'll give you an honest answer — even if that answer is "let's get more testing first."
Risks to be aware of
All major operations carry risks, and recovery varies based on the type of surgery and your overall health. The team monitors your progress closely in the hospital, focusing on pain control and gradually reintroducing food. Long-term recovery involves adjusting to new eating habits and ongoing follow-up with your care team.
Common short-term side effects (expected and temporary)
Expected in recovery
• Bleeding or infection at the surgical site.
• Temporary delay in bowel function.
• Pain that requires oral medication for control.
Serious risks (uncommon)
• A leak from the new surgical connection.
• Injury to nearby organs during the procedure.
• Blood clots, pneumonia, or heart and lung problems.
What recovery looks like
Call your care team immediately for fever, worsening pain, persistent vomiting, or signs of bleeding.
The team monitors pain control, breathing, and initial movement while beginning to track urine output and labs.
Diet advances slowly under surgeon guidance, often starting with clear liquids as bowel function returns.
Patients typically transition to home care once they can eat and walk safely and control pain with oral medicines.
Follow-up appointments begin to monitor healing, weight, and the transition to smaller, more frequent meals.
Ongoing nutrition follow-up helps manage weight, vitamins, and hydration while coordinating with oncology teams.
What to expect long-term
Long-term adjustments include eating smaller, more frequent meals and focusing on protein, vitamins, and minerals. Some patients may experience dumping syndrome, where food moves too quickly into the small intestine, causing nausea or cramping. Regular follow-up with surgery, oncology, and nutrition teams is essential to manage weight and prevent vitamin deficiencies.
Questions about Stomach Surgery (Gastrectomy)
Surgery is an option when the tumor looks removable and you are healthy enough for major surgery. A team of experts, including surgeons, oncologists, and nutritionists, usually makes this decision together. We decide based on the tumor's location, its stage, and your test results. Your overall nutrition and general health also help guide the choice. Sometimes, other treatments like chemotherapy, targeted therapy, or radiation might be needed before surgery is considered. Not every patient needs immediate surgery, and some very early tumors can be treated with a scope exam instead. Dr. Dunn will talk with you about the best path forward based on your specific diagnosis and health needs.
Preparation starts well before your operation. Our team will review your medical history, medicines, and any past surgeries. We also check your heart and lung health. Typical tests include an upper endoscopy with a biopsy to confirm the diagnosis and CT scans to check for any spread. You might also need an ultrasound, MRI, or lab work. If you have lost weight or have trouble eating, a nutrition evaluation is very important. We will also help you plan for your blood thinner and diabetes medicines. Bringing a list of your medicines, allergies, and prior test results to your appointment helps us build a safe and individualized plan for your care.
The surgical plan depends on where the tumor is located and its stage. A subtotal gastrectomy removes only the part of the stomach with cancer, keeping the rest when safe. A total gastrectomy removes the entire stomach and requires reconstruction to reconnect the esophagus to the small intestine. We also remove and test nearby lymph nodes to help stage the cancer. Often, we can use a minimally invasive approach with small incisions and robotic tools to reduce pain and speed up recovery. However, open surgery may be the safest choice depending on the tumor size and your history. Dr. Dunn will recommend the approach that balances your safety with the best possible recovery.
Recovery varies based on your health and the type of operation you had. In the hospital, our team monitors your pain, breathing, and walking. Your diet will advance slowly, starting with clear liquids. Most patients need to eat smaller, more frequent meals after surgery because the way you digest food changes. You will need regular nutrition follow-up to manage your weight and vitamins. It is important to watch for dumping, which happens when food moves too quickly into the small intestine. All major surgeries carry risks like bleeding, infection, or blood clots. We will coordinate your follow-up care with oncology and nutrition experts to help you manage these changes and recover safely.
