Surgery is the most common treatment for stomach cancer, especially when the disease is in the early stages of development. Each year, our doctors perform approximately 200 surgical procedures — including open and minimally invasive surgery — to remove tumors, nearby lymph nodes, and the portion of the stomach that contains the cancer. Memorial Sloan Kettering performs the most surgeries for stomach cancer in the country.
For people with more advanced tumors and in certain other cases, we may also recommend chemotherapy, radiation therapy, or both.
Open Surgery (Gastrectomy)
Depending on the stage of the cancer, we may recommend a partial or total gastrectomy. With a partial gastrectomy, our doctors remove part of the stomach and nearby lymph nodes (called a lymphadenectomy) to determine if they contain cancer cells. Depending on the location of the tumor, we may also remove parts of other organs such as the small intestine or esophagus.
A total gastrectomy is a major operation that we reserve for people with stomach cancer that is advanced but has not spread to other organs. In this procedure, the surgeon removes the entire stomach, several lymph nodes, and parts of the esophagus, small intestine, and other tissue near the tumor.
Surgeons then connect the esophagus to the small intestine so that patients can continue to eat and swallow normally. Depending on the extent of the cancer, the surgeon may also remove part of the pancreas and the spleen, a small organ in the upper abdomen that filters blood and eliminates old blood cells.
Minimally Invasive Surgery (Laparoscopic and Robotic)
For some people with stomach cancer, we can perform partial or total gastrectomy through minimally invasive laparoscopic surgery, in which a surgeon inserts a thin, lighted tube with a video camera at its tip (called a laparoscope) into the abdominal cavity through a tiny incision. The laparoscope projects a highly magnified image of the stomach and surrounding area onto a large viewing screen. Guided by this image, the surgeon performs the operation using specially designed surgical instruments that are inserted through additional small incisions in the abdomen.
Laparoscopic and robotic surgery typically results in less harm to organs and surrounding tissue. Our researchers have shown that laparoscopic surgery is as effective as conventional open surgery and leads to fewer complications, less postoperative pain, and shorter hospital stays (1).
Surgeons at Memorial Sloan Kettering have performed more laparoscopic stomach procedures than any other cancer center in the country.
For some of our patients we are able to offer robot-assisted surgery to perform minimally invasive stomach procedures. In this approach, surgeons perform the operation from a console that displays a magnified three-dimensional image of the abdominal cavity, highlighted with a special fluorescent dye.
The surgeon uses hand, finger, and foot controls to move surgical instruments with greater precision than would be possible with other surgical techniques. While studies have shown that robotic surgery is a safe alternative for some stomach cancer patients, our doctors continue to evaluate the advantages of this approach.