Surgery for stomach cancer

Surgery aims to remove all of the stomach cancer while keeping as much of the stomach as possible. This may involve having several procedures during the operation. The surgeon will also remove some healthy tissue around the cancer to reduce the risk of the cancer returning. Different types of surgery can be used. The type you have will depend on where the cancer is in the stomach.

Learn more about:

• How the surgery is done
• Types of surgery
• Risks of stomach surgery
• Having a feeding tube
• What to expect after stomach surgery

How the surgery is done

The surgery will be done under a general anaesthetic. There are two ways to perform surgery for stomach cancer:

• in a laparotomy (open surgery), the surgeon makes a long cut in the upper part of the abdomen from the breastbone to the bellybutton
• in a laparoscopic surgery (minimally invasive or keyhole surgery), the surgeon will make some small cuts in the abdomen, then insert a thin instrument with a light and camera (laparoscope) into one of the cuts. The surgeon puts tools into the other cuts and performs the surgery using the images from the camera for guidance.

Laparoscopic surgery usually means a smaller scar, which means the hospital stay is shorter and the recovery faster, but it’s not always possible to have this type of surgery. Open surgery may be considered a better option in many situations.

For more on this, see our general section on Surgery.

Types of surgery

Subtotal or partial gastrectomy

Only part of the stomach is removed when the cancer is in the lower part of the stomach. Nearby fatty tissue (omentum) and lymph nodes are also removed. The upper stomach and oesophagus are usually left in place.

Total gastrectomy

The whole stomach is removed when the cancer is in the upper or middle part of the stomach. Nearby fatty tissue (omentum), lymph nodes and parts of nearby organs, if necessary, are also removed. The surgeon rejoins the oesophagus to the small bowel.

Lymphadenectomy (lymph node dissection)

As the cancer might have spread to nearby lymph nodes, your doctor will also remove some lymph nodes from around your stomach. This reduces the risk of the cancer coming back and helps a specialist doctor called a pathologist more accurately work out the stage of the cancer.

Risks of stomach surgery

As with any major operation, surgery for stomach cancer has risks. Your surgeon will talk to you about the risks and complications of stomach surgery. These may include infection, bleeding, damage to nearby organs, or leaking from the joins between the small bowel and either the oesophagus or stomach. Some people’s heartbeat can become irregular, but this usually settles in a few days.

You will be carefully monitored for any side effects. For more information about ongoing effects after surgery, see Managing side effects.

→ READ MORE: Having a feeding tube

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