Name: Amal-Jahedah G.

Lucman
NSG124 (Pain and Surgery)
Topic Manuscript: GASTRECTOMY

Definition and Description of the Surgical Procedure:

STOMACH- is a J-shaped organ that processes nutrients and digestion. After eating, the food that
is partially digested by the stomach is then passed into the intestines. There, it continues to be
processed.
Gastrectomy is a partial or total surgical removal of stomach. There are four main types of
gastrectomy namely: Partial Gastrectomy is defined as the removal of a part of the stomach. Which
is usually done in the lower half of the stomach. Full or Total Gastrectomy removal of the entire
stomach. Sleeve Gastrectomy the removal of the left side of the stomach. This is usually performed
as part of a surgery for weight loss. Esophagogastrectomy the top part of the stomach and part of
the esophagus (gullet), the tube connecting your throat to your stomach, is removed. Removal of
stomach does not take the ability to digest foods and liquid but lifestyle changes may need to be
altered or changed completely.
Purpose:
Gastrectomy is usually used to treat stomach problems that could not be treated is a normal way.
The following is recommended to be treated in gastrectomy: Benign or noncancerous tumors,
Bleeding, Inflammation, Perforation in the stomach wall, Polyps or growth inside your stomach,
Stomach cancer, and Severe peptic or duodenal ulcers
Gastrectomy can also be used as a treatment for obesity.
Procedure:
There are two known ways to perform gastrectomy. Both are performed under general anesthesia.
Open Surgery involves a single large incision. The attending surgeon will have to pull back skin,
muscle, and tissue to access the stomach. Laparoscopic Surgery it is minimal invasive procedure.
It involves small incision and the use of specialized machines. It is less painful and allows a fast
recovery time. And it is known as the keyhole surgery or the laparoscopically assisted gastrectomy
(LAG).
LAG is preferred more than open surgery because it is more advanced and requires less risks and
complications.
Equipment, Instruments, and Supplies Needed for the Surgical Procedure:
Equipment, Instruments, and Supplies for both Open Surgery and Laparoscopic Surgery are as
follows: Laparoscopic tray with full set of instruments, Grasper, Dissectors, Endoscopic
Gastrointestinal Anastomosis (EGA) stapler, Suture, Scalpel, Bowel Clamps, Calipers and Gauges,
Curettes, Dissectors and Probes, Elevators and Spreaders, Forceps and Graspers, Gouges,
Osteotomies, and Rongeurs, Hooks, Instrument Handles, Knives, Needle Holders, Retractors,
hand-held and self-retaining, Scissors, and Suction Tubes.
Risk and Complication:
The risk for gastrectomy includes acid reflux, diarrhea, gastric dumping syndrome, infection of
wound, infection in chest, internal bleeding, leaking from the stomach at the operation site, nausea,
vomiting, stomach acid leaking into the esophagus, blockage of small bowel, vitamin deficiency,
overwhelming weight loss, bleeding, difficulty breathing, pneumonia, and damage to other organs.
Nursing Responsibilities:
 Pre-Operative
Insert a nasogastric tube if ordered preoperatively. Although it is often inserted in the surgical site
just before the surgery, the nasogastric tube may be placed preoperatively to remove secretions
and empty stomach contents.
Name: Amal-Jahedah G. Lucman
NSG124 (Pain and Surgery)
 Intra-Operative
Monitor vital signs
Assess airway patency
Assist and be attentive
Not anticipated length of procedure and assist the client into a comfortable position
 Post-Operative
Assess position and patency of nasogastric tube, connecting it to low suction. Gently moisten with
sterile normal saline if tube becomes clogged.
Assess color, amount, and odor of gastric drainage, noting any changes in these parameters or the
presence of clots or bright bleeding. Initial drainage is bright red. It becomes dark, then clear or
greenish-yellow over the first 2 to 3 days. A change in the color, amount, or odor may indicate a
complication such as hemorrhage, intestinal obstruction, or infection
Maintain intravenous fluids while nasogastric suction is in place. The client on nasogastric suction
is not only unable to take oral food and fluids but also is losing electrolyte-rich fluid through the
nasogastric tube. If replacement fluid and electrolytes are not maintained, the client is at risk for
dehydration imbalances of sodium, potassium, and chloride; and metabolic alkalosis.
Provide antiulcer and antibiotic therapy as ordered.
Monitor bowel sounds and abdominal distention. Bowel sounds indicate resumption of peristalsis.
Increasing distention may indicate third-spacing, obstruction or infection.
Encourage ambulation. Ambulation stimulate peristalsis.
Teach the client about potential postoperative complications, such as abdominal abscess, dumping
syndrome, postprandial hypoglycemia, or pernicious anemia. Also, teach the client to recognize
signs and symptoms and preventive measures.
Consult with a dietitian for diet instructions and menu planning.
Published Article Related with the Procedure:
A. ABSTRACT
Sleeve gastrectomy is a surgical technique and a leading method in metabolic surgery. Sleeve
gastrectomy gained ever-increasing popularity among laparoscopic surgeons involved in bariatric
surgery and has proved to be a successful method in achieving considerable weight loss in a short
time. There are some disparate effects that patients may experience after sleeve gastrectomy
including a reduction in BMI, weight, blood pressure, stroke, and cancer and also a significant
remission in obesity-related diseases including type 2 diabetes (T2D), Non-alcoholic fatty liver
(NAFLD), cardiovascular disease, obstructive sleep apnea, and craniopharyngioma-related
hypothalamic obesity as well as non-obesity-related diseases such as gout, musculoskeletal
problems, ovarian disorders and urinary incontinence. The most common complications of sleeve
gastrectomy are bleeding, nutrient deficiencies, and leakage. There are several studies on the
impact of gender and ethnic disparities on post-operative complications. This study collects state of
the art of reports on sleeve gastrectomy. The aim of this study was to analyze recent studies and
review the advantages and disadvantages of sleeve gastrectomy.
B. INSIGHTS
As I have read, the definition of sleeve gastrectomy. I was amazed by it overwhelming benefit for
obese patient but upon reading this article I have come to realize that sleeve gastrectomy is still a
surgical procedure which hold great risks.
Name: Amal-Jahedah G. Lucman
NSG124 (Pain and Surgery)
References:

Gonzalez, A. (2018). Gastrectomy. Healthline.https://www.healthline.com/health/gastric-sleeve-diet

Overview: Gastrectomy. (2018). NHS. https://www.nhs.uk/conditions/gastrectomy/

Stein, F.(2016). The client having gastric surgery. Nursing Care.

https://wps.prenhall.com/wps/media/objects/737/755395/gastric_surgery.pdf

Harris, H., Rogers, S., Carter, J. (2018). Gastrectomy. USCF General Surgery. Department of Surgery.
https://generalsurgery.ucsf.edu/conditions--procedures/gastrectomy.aspx

Oncolink Team.(2020). Surgical Procedure: Gastrectomy. Oncolink Organization.

https://www.oncolink.org/cancers/gastrointestinal/gastric-cancer/treatment-options-for-gastric-
cancer/surgical-procedures-gastrectomy

Ramanathan, R., Gourash, W., Ikramuddin, S., Schauer, P. (2019). Equipment and Instrumentation for
Laparoscopic Bariatric Surgery. https://my.clevelandclinic.org/ccf/media/files/Bariatric_Surgery/equip.pdf

Bariatic Surgical Instrument. (2018). Millennium Surgical. https://www.surgicalinstruments.com/general-

lap-bariatric-instruments/bariatric-surgical-instruments

Surgery (Perioperative Client) Nursing Care Plans (2019). RNPedia. https://www.rnpedia.com/nursing-

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