Skilled, experienced surgeons use many approaches to correct stomach conditions
Aria general surgeons can offer surgery for the stomach, in cases were this organ needs to removed, repaired, or modified. Our experienced staff uses the most up-to-date techniques to increase the effectiveness, and decrease the invasiveness and time needed for recovery, in these operations.
Aria's team always considers whether patients can benefit from undergoing conservative therapy first. Nonsurgical means are preferred where possible. Specialists in Aria's Division of Gastrointestinal Disease can offer the latest in evaluation and medical care for many conditions that (in some cases, however, that are untreated, are unresponsive to noninvasive treatment, or have progressed to a severe stage) may lead to the need for surgical care. Gastroenterologists at Aria are highly experienced, for example, in diagnosing and treating ulcers, gastroparesis, stomach dumping, and dysphagia.
Surgery for Acid Disease
Many people suffer from overproduction of stomach acid. For some individuals, conservative means of treating this condition, through lifestyle adjustments and medication, are not adequately effective. Sometimes these patients suffer from stomach ulcers that do not respond to medical treatment and that thus fail heal as a result of drug therapy or other noninvasive interventions.
This situation is much less common today, with the increasingly effective classes of drugs that have become available for acid disease and with knowledge about the role of H. pylori bacteria in causing stomach ulcers (which can sometimes be addressed with antibiotic therapy).
But when an untreatable ulcer condition becomes severe enough to cause complications such as obstructions, bleeding, or perforations in the GI tract, the medical team may recommend one of number of possible operations:
• surgery for the stomach nerve. In this operation, called a vagotomy, the surgical team cuts the nerve that stimulates production of stomach acid. The surgeon may cut the base of the vagal nerve or some or all of its branches that affect different parts of the stomach. Often, vagotomies are performed under emergency circumstances, where complications have required immediate intervention.
• pyloric sphincter release. In this operation, called a pyloroplasty, the surgical team resects the lower portion of the stomach to relax and widen the muscular opening (pyloric sphincter) to permit freer passage of food out of the stomach and into the intestine.
• partial stomach removal. If areas of stomach tissue are severely compromised by acid disease, the medical team my recommend removing these portions of the stomach, in an operation called a partial gastrectomy.
The surgical team often performs more than one of these operations at the same time, to give the patient maximum curative benefit.
Surgery for Stomach Cancer
Partial or complete removal of the stomach (gastrectomy) is a standard treatment for stomach cancer. For more on surgery for stomach cancer, see Aria’s Division of Surgical Oncology.
Surgery for Gastroparesis
In rare cases when medical treatment for gastroparesis is ineffective and symptoms are severe (including when the condition prevents nutrients and medications from reaching the bloodstream), the medical team may recommend surgery:
• Surgeons may place venting tubes through the skin on the abdomen and into the stomach. This step can reduce vomiting and dehydration. Such gastrostomy tubes help to vent air that may be causing these symptoms, due to a stomach that is not contracting properly. A double-channeled gastrostomy tube may also permit feeding directly into the stomach.
• Or, surgeons may perform a procedure called jejunostomy, in which a feeding tube is inserted through the skin on the abdomen into the small intestine. This tube then allows nutrients to be put directly into the small intestine, bypassing the stomach.
• In other cases, the surgical team will staple or bypass a portion of the stomach to improve its ability to empty. Surgeons may reattach the small intestine to the remaining stomach to improve emptying of stomach contents.
• In very rare cases, the patient will undergo complete removal of the stomach.
• Gastric electrical stimulation is also an option. In this newer procedure, surgeons implant a device that paces the contractions of the stomach.
Surgery for Stomach Dumping
In gastric dumping, the stomach moves food too quickly into the small intestine. If medical therapy fails, doctors may recommend surgery to increase the stomach’s ability to control food release. This involves reconstruction of the pyloric sphincter muscle or reversal of the effects of other types of stomach surgery, which can sometimes cause this problem.
Surgery for Dysphagia (inability to swallow)
Patients who are unable to eat normally due to dysphagia may need to have a tube implanted in the stomach, so that they can receive liquified nutrition and hydration through the tube. A general surgeon may place this tube either by accessing the stomach orally (through the mouth) with an endoscope or by making an incision in the skin of the abdomen. The surgeon stitches the stomach closed around the tube. The tube stays in place and requires special care by the patient. If the tube needs to be in place for a long time, it may occasionally need to be replaced by the surgeon in a simple procedure.
Aria Health does not currently offer gastric bypass (bariatric surgery). In this operation, a surgical team removes a portion of the stomach and small intestine as treatment for severe obesity.
In some cases, the team may be able to perform these various types of stomach surgery laparoscopically, rather than through traditional open incision. Even when performed laparoscopically, though, stomach operations are major surgery that requires general anesthesia, a hospital stay of approximately a week, and healing and recovery time of several weeks. In the days after the operation, patients gradually return to a normal diet. These operations do not provide a guarantee that a stomach condition such as ulceration will not return. Patients receiving laparoscopic operations will normally experience faster recovery.