Anesthesia to remove the entire stomach

This is an automatically translated article.

The article was consulted with an Anesthesiologist - General Surgery Department - Vinmec Nha Trang International General Hospital.

1. Learn about gastric bypass surgery

Gastrectomy is surgery to remove part or all of the stomach, usually after other conservative treatments have failed. Total gastrectomy is often used to treat some serious conditions such as:
Stomach cancer. Benign gastric tumors. Gastric ulcer or perforation of the stomach. Fat . For a total gastrectomy, the doctor needs to connect the esophagus (the tube-shaped organ that goes from the mouth to the stomach) to the small intestine. This will help the patient to have normal digestion.

2. Surgical techniques for total gastrectomy

Currently, to perform gastrectomy, depending on the patient's condition such as health, disease stage..., doctors can choose one of two main surgical techniques as follows:
Open surgery: doctor An extra-abdominal incision is made and then a partial/complete gastrectomy is performed. After gastrectomy, the doctor needs to connect the remaining sites together with specialized tools. The open surgery method is a traditional and highly popular type of surgery. However, this method will leave scars, cause more pain and have more risks/complications after surgery. Laparoscopic surgery: laparoscopic gastrectomy has been widely applied in hospitals. In this method, the doctors only make a small incision on the abdomen and put inflatable and surgical instruments into the abdomen to perform gastrectomy. This method has many advantages such as high accuracy, safety, less pain and less scarring than open surgery.

3. How is total gastrectomy performed under general anesthesia?

Anesthesia is an important preparatory phase before total gastrectomy. The anesthetic technique indicated in this case is usually endotracheal anesthesia combined with regional anesthetic measures to provide the best pain relief during and after surgery.
This technique will put the patient under general anesthesia and intubate at the same time. This maneuver will support the patient's breathing control during the surgery as well as the postoperative recovery period.

Drugs and equipment to be prepared before anesthesia Anesthesia drugs include:
Sleeping pills: intravenous anesthetics such as propofol, thiopental, ketamine, etomidate..., volatile anesthetics sevoflurane, isoflurane.. Analgesics: sufentanil, morphine, fentanyl... Muscle relaxants such as succinylcholine, rocuronium, vecuronium... Anesthetic drugs for pain relief such as: Ropivacain, Chirocain, Bupivacaine... Technical means of anesthesia including:
Anesthesia system, hand-held oxygen source, life function monitors such as ECG, arterial blood pressure, temperature, breathing rate, EtC02, SPI pain monitoring, BIS anesthesia monitoring , monitoring NMT or TOF muscle relaxation, defibrillator, ultrasound machine to numb the pain relief area... Laryngoscope, squeeze balloon, suction tube, mask, endotracheal tube of all sizes... Lidocaine 10% and Salbutamol spray. Some other means to prevent difficult intubation cases such as laryngeal mask, flexible bronchoscope, mouth opening pliers, tracheostomy kit, cricothyroid opening...

4. What do patients need to prepare before performing anesthesia – total gastrectomy?

Before surgery, the patient should have a pre-anaesthetic examination at least a few days before surgery. This pre-anesthesia visit will include: checking the results of basic laboratory tests (such as: chest X-ray, ultrasound, electrocardiogram), blood tests, adding other tests if necessary, and evaluation. overview the patient's health status (based on age, comorbidities, psychological status...), discuss anesthetic measures, anesthesia will be applied to help patients feel secure, Thorough preparation, stable treatment of comorbidities to ensure safety and tolerance for surgical anesthesia.

The night before surgery and the next morning, the patient must shower with an antiseptic solution. Also from the night before this surgery, the patient must fast (for how long will be fully instructed by the doctor) and only take the necessary drugs for surgery - anesthesia (such as sedatives, Medicines to treat diseases are available after being examined, tested and guided by a doctor).
For the case of pyloric stenosis, the patient must wash the stomach before performing anesthesia - surgery.

5. After gastric bypass surgery, what should the patient pay attention to to promote the recovery process?

Usually, a patient needs to stay in the hospital for about 4-7 days after a gastrectomy, especially in the case of an open total gastrectomy. During this time, doctors can perform postoperative pain relief techniques, put a tube through the nose to the stomach to remove fluid, limit nausea, and help the patient heal faster. Regarding nutrition, doctors will feed patients in the form of intravenous infusion. This will be done until the patient is able to eat and drink normally.
Recovery after gastrectomy takes a certain amount of time. Therefore, the diet needs to be adjusted as follows:
The meals of the day need to be divided into several meals. Do not eat foods rich in fiber. Increase foods rich in amino acids, iron, calcium, vitamin C and vitamin D. In general, total gastrectomy is a major surgical procedure aimed at treating complex pathologies. Therefore, the conduct of this surgery needs to be careful in every step, even the preparation stage. Therefore, you need to go to reputable hospitals and have full equipment for anesthesia - surgery to increase treatment efficiency and ensure safety.
In order to minimize complications during and after surgery, now, Vinmec International Hospital has put a system of modern machinery and equipment for surgical anesthesia up to standard in examination and diagnosis. Diagnosis, anesthesia and treatment of diseases related to stomach and digestive system. With a team of highly qualified and well-trained medical doctors, they will bring optimal treatment efficiency and minimize complications for customers.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.