Gastrectomy (Stomach Removal) in Delhi, India

Gastrectomy is a major surgical operation that involves partial or complete removal of the stomach. It is primarily performed to treat malignant (cancerous) or benign (non-cancerous) conditions that cannot be managed effectively through less invasive means. The extent of the removal depends on the specific condition being treated, its size, location, and spread. By removing the diseased portion of the stomach, surgeons aim to eliminate the source of the problem, alleviate symptoms, and improve long-term prognosis.

Gastrectomy procedures can be broadly categorised based on the extent of stomach removal and the surgical approach used. At Max Hospitals, our surgeons carefully select the most appropriate approach depending upon the patient’s medical condition, the location and extent of the disease within the stomach, and the patient's overall health.

Partial Gastrectomy

In a partial gastrectomy, only a section of the stomach is removed, while the remaining part continues to function in digestion. It is typically used when the disease is localised to a specific region of the stomach. Partial gastrectomy can further be categorised as

1. Distal Gastrectomy

This involves removal of the lower portion of the stomach, often along with nearby lymph nodes. It is commonly performed to treat gastric ulcers or cancers located in the antrum or pyloric region.

2. Proximal Gastrectomy

This procedure removes the upper portion of the stomach, including the cardia and sometimes the gastroesophageal junction. It is often indicated for cancers or lesions situated near the top of the stomach.

3. Subtotal Gastrectomy

A substantial part of the stomach is removed, but not the entire organ. Depending on the tumour’s location, the procedure may involve either the upper or lower stomach. It allows preservation of some gastric function while effectively removing the diseased tissue.

Total Gastrectomy

In a total gastrectomy, the entire stomach is removed, usually for widespread or high-risk malignancies. The oesophagus is surgically connected to the small intestine to maintain continuity of the digestive tract. This procedure significantly alters digestion and requires long-term dietary adjustments and supplementation.

Sleeve Gastrectomy

This bariatric procedure removes approximately 75–80% of the stomach, leaving behind a narrow, sleeve-shaped tube. Although originally developed for weight loss, it may also be used in some non-cancerous gastric conditions. It restricts food intake and influences hormone levels involved in hunger and metabolism.

Wedge Resection

Wedge resection is a limited surgery in which a small, wedge-shaped section of the stomach wall is excised. It is typically reserved for localised benign tumours such as gastrointestinal stromal tumours (GISTs) that do not require major resections. This technique preserves most of the stomach’s normal anatomy and function.

Open Gastrectomy

Open gastrectomy involves a large abdominal incision to provide direct access to the stomach. This method offers a clear view of the abdominal cavity and is often preferred in complex cases, large tumours, or when extensive lymph node dissection is required.

Laparoscopic Gastrectomy

Laparoscopic surgery is minimally invasive and uses small incisions through which a camera and instruments are inserted. This technique generally results in faster recovery, reduced post-operative pain, and fewer complications.

Robot-assisted Gastrectomy

Robot-assisted surgery uses robotic arms controlled by the surgeon for enhanced precision and visualisation. It allows fine movements in confined spaces and may reduce blood loss and post-operative discomfort.

Gastrectomy is typically considered when other treatment options are no longer effective or appropriate. It is most often performed to manage serious or potentially life-threatening conditions affecting the stomach. While cancer remains one of the primary reasons, gastrectomy is also used to address a range of non-cancerous but severe disorders, including persistent ulcers, traumatic injuries, and uncontrollable bleeding. In some cases, such as morbid obesity, the procedure is done to improve long-term health outcomes. Below are the primary medical reasons why a gastrectomy may be recommended:

• Stomach Cancer (Gastric Cancer): This is one of the most common reasons for gastrectomy. The surgery removes cancerous tissue, surrounding healthy margins, and often regional lymph nodes to achieve a curative outcome, particularly in resectable stages.
• Severe Peptic Ulcers: For ulcers that are deep, chronically bleeding, perforated (have created a hole in the stomach wall), or resistant to extensive medical therapy, gastrectomy may be necessary to remove the affected part and prevent life-threatening complications.
• Benign Tumors or Polyps: Large or symptomatic non-cancerous growths in the stomach that could potentially become malignant or cause significant issues (like bleeding or obstruction) may require removal via gastrectomy.
• Severe Gastrointestinal Bleeding: When bleeding from the stomach is persistent, severe, and cannot be controlled by endoscopic or other non-surgical methods, a gastrectomy may be performed as a life-saving measure.
• Gastric Perforation: In cases where there is a hole in the stomach wall due to trauma, ulceration, or other causes, a gastrectomy might be necessary to remove the damaged area and repair the defect, especially if there's significant tissue damage.
• Morbid Obesity (Sleeve Gastrectomy): For individuals suffering from severe obesity and associated health problems, sleeve gastrectomy is a highly effective surgical option to promote significant and sustained weight loss when other methods have failed.
• Gastrointestinal Stromal Tumors (GISTs): These are rare but can occur in the stomach. Surgical removal via gastrectomy is often the primary treatment.
• Enhanced Prognosis: For many conditions, particularly cancer, gastrectomy offers the best chance for complete disease removal and long-term survival, especially when combined with other therapies like chemotherapy or radiation.

Gastrectomy is a major surgical procedure that, like any significant operation, carries inherent risks and potential complications. While at Max Hospitals, we prioritize patient safety by employing rigorous protocols, state-of-the-art technology, and highly experienced teams to significantly mitigate these, we also ensure that patients and their families are thoroughly counselled about potential complications before they agree to undergo the procedure. Here are some of the common risks involved:

• Bleeding: Significant blood loss can occur during or after surgery, potentially requiring blood transfusions.
• Infection: Risks include surgical site infections, pneumonia, or intra-abdominal infections. Strict aseptic techniques and prophylactic antibiotics are used to minimize this risk.
• Nutritional Deficiencies: After gastrectomy, especially total gastrectomy, patients may experience difficulties absorbing nutrients, leading to deficiencies in vitamins (e.g., B12), iron, and calcium.
• Dumping Syndrome: This common complication occurs when food moves too quickly from the stomach (or esophagus) into the small intestine, causing symptoms like nausea, vomiting, dizziness, cramping, and diarrhea, particularly after eating sugary or high-fat foods.
• Bile Reflux Gastritis: Bile from the small intestine can reflux into the remnant stomach or esophagus, causing irritation and inflammation.
• Stricture: Scarring at the surgical connection site can narrow the passage, leading to difficulty swallowing or food passing through.
• Anastomotic Leak: This is a serious complication where the connection site between the remaining stomach (or esophagus) and the small intestine leaks digestive fluids into the abdominal cavity, potentially leading to infection and requiring further intervention.
• Pain: Patients can expect varying degrees of pain following gastrectomy, resulting from the incision and internal tissue manipulation. However, at Max Hospitals, robust and personalised pain management protocols are implemented to ensure comfort, facilitate early mobilization, and support a smoother recovery.
• Blood Clots: Deep vein thrombosis (DVT) in the legs or pulmonary embolism (blood clot traveling to the lungs) can occur. 
• Organ Injury: Accidental injury to surrounding organs (e.g., spleen, liver, pancreas) during surgery is a rare but possible complication.
• Anesthesia Risks: Adverse reactions to anesthesia, though rare, can occur.

Factors That May Increase the Risk:

• Advanced age
• Pre-existing heart, lung, or kidney disease
• Diabetes or other chronic medical conditions
• Obesity
• Smoking history
• Poor nutritional status prior to surgery
• Extent and complexity of the underlying disease (e.g., advanced cancer)

Minimising Gastrectomy Risks 

At Max Hospitals, we minimise risks by:

• Performing thorough preoperative assessments, including detailed cardiac, pulmonary, and nutritional evaluations.
• Utilising advanced surgical techniques, including minimally invasive (laparoscopic and robotic) approaches where appropriate. 
• Employing highly experienced gastrointestinal and surgical oncology teams and anaesthesiologists.
• Implementing stringent infection control protocols.
• Providing aggressive postoperative pain management.
• Encouraging early mobilisation and offering comprehensive nutritional counseling and support.
• Ensuring close monitoring in dedicated intensive care and recovery units.

At Max Hospitals, we are dedicated to supporting patients through every phase of their gastrectomy journey. Right from the initial consultation to the surgical procedure to post-operative recovery, we ensure meticulous planning, precise execution, and optimal recovery.

Pre-Surgery Preparation Phase

The preparation phase for gastrectomy is designed to ensure optimal surgical outcomes through thorough evaluation, planning, and patient readiness. This phase plays a vital role in minimising risks and facilitating smoother recovery.

Comprehensive Diagnosis 

The process begins with an in-depth assessment of the patient’s medical history, supported by advanced diagnostic tests. These include essential blood investigations, detailed imaging studies like CT, MRI, and PET scans, and an upper GI endoscopy with biopsy for precise insights. Nutritional and cardiac evaluations are also conducted as indicated, helping to determine the disease stage, assess overall fitness for surgery, and guide the precise treatment plan.

Multidisciplinary Preoperative Planning 

A team of specialists works together to create a tailored surgical approach for each patient. The team typically includes experienced gastrointestinal surgeons, medical oncologists (especially in cancer cases), gastroenterologists, skilled anesthesiologists, and expert clinical dietitians. This multidisciplinary collaboration ensures that all aspects of the patient’s condition are thoroughly addressed and integrated into the care plan before surgery.

Preoperative Optimisation

Improving the patient's overall health status is essential for a better surgical recovery. Preoperative optimisation may involve the temporary discontinuation or adjustment of specific medications, such as blood thinners, as well as nutritional enhancement through high-protein diets or supplements. Patients are also strongly advised to cease smoking and alcohol consumption. Light physical activity may be recommended, as advised, to improve general fitness. These proactive steps collectively help reduce potential complications and support faster healing post-surgery.

Pre-Surgical Instructions and Planning

Patients receive clear and detailed guidance crucial for the day of surgery and their hospital stay. This includes fasting requirements before surgery, a checklist of items to carry on the day of admission, and a clear outline of the expected sequence of events on the day of surgery and during their hospital stay. Pre-admission visits may also be arranged to familiarise patients and their caregivers with the hospital environment and the dedicated care teams, helping to alleviate any last-minute anxieties.

Emotional Support and Family Counseling

Recognising that gastrectomy can lead to significant physical and emotional changes, Max Hospitals provides dedicated support to help manage this transition. Psychological counseling is offered to address any patient anxiety or concerns, and detailed discussions are held with caregivers to prepare them comprehensively for post-surgical care and necessary nutritional adjustments. Our compassionate support staff remain readily available to answer queries and provide reassurance throughout the entire process.

On the Day of the Surgery

On the day of surgery, patients are cared for by our highly skilled surgical and nursing teams in state-of-the-art operating theatres.

Anaesthesia Administration & Positioning

The patient is carefully positioned on the operating table and administered general anesthesia, ensuring complete comfort and unconsciousness throughout the procedure. During the procedure, vital signs are continuously monitored for utmost safety.

Surgical Access

Depending on the patient's condition, disease extent, and overall health status, surgeons may opt for either an open gastrectomy or a minimally invasive approach such as laparoscopic or robot-assisted surgery.

Stomach Resection & Reconstruction

The diseased portion of the stomach or the entire stomach is meticulously removed. For cancer cases, surrounding lymph nodes are also carefully excised. The remaining parts of the digestive tract (e.g., esophagus to small intestine, or remaining stomach to small intestine) are then reconnected using advanced surgical techniques.

Closure & Transfer

Once the procedure is complete, surgical drains may be placed if clinically indicated, and the incisions are carefully closed. The patient is then transferred to the recovery area or Intensive Care Unit (ICU) for close monitoring, as anaesthesia wears off and initial post-operative recovery begins.

Post-Surgery Recovery Phase

Recovery after gastrectomy is a gradual process. At Max Hospitals, we are committed to providing continuous medical, nutritional, and emotional support throughout the recovery journey, both during the hospital stay and after discharge. Here are the key areas we focus on to help patients recover safely and comfortably.

Pain Management & Early Mobilisation

During the early hospital stay and the first days at home, managing pain and encouraging gentle movement are key parts of recovery. We use modern pain relief methods, such as epidurals and patient-controlled pain medication, to help patients stay comfortable. Sitting up, standing, and walking short distances (with help if needed) are encouraged to prevent problems like blood clots and chest infections, and to support healing.

Fluid & Nutritional Management

Learning to eat in a new way is an important step after a gastrectomy. Our dietitians guide patients through each stage, starting with fluids, then soft foods, and finally moving to a modified normal diet. Patients are advised to eat smaller, more frequent meals, chew food well, and manage symptoms like “dumping syndrome.” Long-term nutritional care, including supplements such as vitamin B12, iron, and calcium, is often needed and tailored to each person’s needs.

Physical Rehabilitation & Incision Care

We help patients slowly regain their strength and keep the surgical area healing well. Our physiotherapists offer gentle exercises to improve movement, especially in the shoulder and upper body. Activity levels are increased gradually, while avoiding heavy lifting or intense effort for several weeks. Patients also receive clear advice on how to care for their wound at home, with nursing support provided for managing surgical drains during the hospital stay.

Long-Term Follow-Up & Emotional Well-Being

Recovery continues well after leaving hospital, and we offer regular follow-up to keep track of progress. Appointments with the surgeon, dietitian, and other specialists help check healing, nutrition, scans, and any further treatment needs. We understand that such major surgery can also affect emotional health, so we offer support through counselling and patient groups to help individuals and families adjust and cope.

For a life-altering and complex procedure like gastrectomy, choosing a hospital with a proven track record of excellence, advanced infrastructure, and a patient-first approach is essential. Max Hospitals stands as a beacon of trust and expertise in gastrointestinal and oncological surgery. Here’s why patients and their families choose us:

• Leading Surgical Expertise: Our teams comprise highly experienced gastrointestinal surgeons and surgical oncologists specialising in complex gastric procedures. Together, they bring vast expertise in both traditional open surgeries and advanced minimally invasive techniques, including laparoscopic and robot-assisted gastrectomies.
• Integrated Multidisciplinary Care: We believe in a holistic approach to care. Our team, including gastroenterologists, surgical oncologists, medical oncologists, anesthesiologists, dietitians, and rehabilitation experts, collaborate closely on each patient's case.
• Advanced Technology and Infrastructure: Max Hospitals is equipped with state-of-the-art operating theatres, advanced imaging capabilities, and robotic-assisted surgical systems. Our modern ICUs allow close post-operative monitoring, in turn, contributing to enhanced precision, safety, and recovery.
• Unwavering Patient Safety: Patient safety is paramount at Max Hospitals. We adhere to stringent patient safety protocols, focusing on meticulous pre-operative assessment, infection control, and continuous monitoring to minimise risks and ensure a smooth recovery.
• Comprehensive Post-Operative Support: Our commitment extends well beyond the surgery. We provide structured pain management, personalised nutritional counseling, guided physical rehabilitation, and robust long-term follow-up to support sustained health and well-being.

How long will I have to stay in the hospital after a gastrectomy?

Hospital stays typically range from 5 to 10 days, depending on the complexity of the surgery, the type of gastrectomy performed, your recovery progress, and the presence of any complications.

Will I be able to eat normally after a gastrectomy?

Your diet will change significantly. You will need to eat smaller, more frequent meals (6-8 times a day), chew food thoroughly, and avoid drinking large amounts of fluid with meals. Your dietitian will provide detailed guidance.

How long does it take to fully recover from a gastrectomy?

Full recovery is a gradual process that can take several weeks to several months (typically 2-6 months), depending on your overall health, the extent of the surgery, and your adherence to dietary and rehabilitation guidelines.

Will I experience pain after gastrectomy?

Gastrectomy is a major surgery, and pain is expected. However, at Max Hospitals, we employ advanced pain management techniques (e.g., epidurals, nerve blocks, patient-controlled analgesia) to ensure your pain is effectively controlled, allowing for earlier mobilization and recovery.

What is Dumping Syndrome?

Dumping syndrome occurs when food moves too quickly into the small intestine after gastrectomy. Symptoms include nausea, cramping, dizziness, and diarrhea. It's common, especially after total gastrectomy, but can be managed effectively with dietary modifications. Your dietitian will provide strategies to minimize its impact.

Will I need vitamin supplements after gastrectomy? 

Yes, especially after total gastrectomy, you will likely need lifelong Vitamin B12 injections, as well as iron and calcium supplements, due to impaired absorption. Your doctor and dietitian will monitor your levels and advise.

Can I return to my normal activities after gastrectomy? 

Most patients can gradually return to their normal daily activities. Strenuous activities, heavy lifting, and activities that strain the abdominal muscles will need to be avoided for several weeks to months, as guided by your surgeon.

Will I have a large scar from the gastrectomy? 

For open gastrectomy, there will be a noticeable scar on your abdomen. If a laparoscopic or robotic approach is used, you will have several smaller scars, which are generally less noticeable.

What signs should I watch for after returning home from a gastrectomy? 

You should immediately contact your doctor if you experience fever (above 101°F or 38.3°C), increasing redness, swelling, or pus from the incision, severe or worsening abdominal pain, persistent vomiting, severe diarrhea, or difficulty swallowing.

Will I need additional treatments after gastrectomy for cancer? 

If gastrectomy was performed for cancer, additional treatments such as chemotherapy, radiation therapy, or targeted therapy might be recommended depending on the stage and type of cancer. Your oncology team will develop a comprehensive post-surgical treatment plan.

What kind of follow-up care is required after gastrectomy? 

Regular follow-up appointments with your surgeon, gastroenterologist, oncologist (if for cancer), and dietitian are crucial. These appointments will involve monitoring your recovery, nutritional status, reviewing imaging scans, and adjusting any ongoing treatment or rehabilitation plans.

Reviewed by Dr BP Singh, Director - Gastroenterology, Hepatology & Endoscopy, on 29 August 2025.