Steps Shared by Total and Subtotal Gastrectomy

There is no substitute for a well-planned and conducted operation on the stomach to provide the best possible surgical outcome. Correct and stable positioning of the patient is the first step for a successful operation, as well as a careful monitoring of the vital parameters by the anesthetist and a great attention on prevention and control of intraoperative hypothermia and of postoperative pain and malnutrition. Incision should be tailored on the surgical procedure and type of patient in order to provide the best exposure of the operating field, minimizing the risk of operation site infection. Exploration of the abdominal cavity and intraoperative cytology of peritoneal fluid or lavage are of paramount importance for tumor staging and prognosis. Then operation goes on through a gentle approach toward any anatomical structure and following precise steps of the surgical procedure. Detachment of the greater omentum from the transverse colon is followed by the division of the right gastroepiploic pedicle and of the pyloric vessels. The duodenum is then closed and resected. Finally, the left gastric vein and artery are divided.