Gastrojejunostomy

A gastrojejunostomy is the surgical procedure of an opening in the stomach to connect it to the upper portion of the small bowel, or small intestine, so that the surgeon can place a tube into the opening. The tube allows medications and nutritional liquids to be given through the tube directly into the stomach.

Symptoms

  • Vomiting
  • Weight loss
  • Nausea
  • Weakness
  • Crampy abdominal pain

The surgery performed with the laparoscopic procedure which will make about 3-4 small incisions in your abdomen. A port (nozzle) is inserted into one of the cuts, and carbon dioxide gas inflates the abdomen. This process allows the surgeon to see inside of your abdomen more easily. A laparoscope is inserted through another slit. The laparoscope looks like a telescope with a light and camera on the end so the surgeon can see inside the abdomen. Surgical instruments are placed in the other small openings and used to connect the small intestine (jejunum) to the stomach. This is done with surgical staplers. After this has been accomplished, the carbon dioxide is released out of the abdomen through the slits, and then these sites are closed with sutures or staples, or covered with glue-like bandage and steri-strips.

The primary risks of laparoscopic gastrojejunostomy are:

  • Postoperative ileus (the intestines slow down/stop working for several days)
  • Infection of the skin at one of the small ports sites
  • Collection of pus inside your abdomen (intraabdominal abscess)
  • Leakage of the connection between the stomach and small bowel
  • Small bowel obstruction (kinking of the small bowel, causing blockage)

Your recovery usually can go home in 2-4 days after a laparoscopic gastrojejunostomy. You may need to wait until your bowels start working. You will be given medication for pain. You should limit your activity to light lifting (no more than 15 lb) for one month.

Vagotomy

Laparoscopic vagotomy is a minimally invasive procedure to remove part of the vagus nerve in the esophagus, using a tiny video camera (laparoscope) and other instruments inserted through several small “keyhole” incisions in the abdomen. The vagus nerve functions in acid production and signals hunger to the brain; vagotomy was traditionally used to reduce stomach acid secretions, but more recently the procedure has been used to reduce hunger in obese patients.

The major side effects of vagotomy are:

  • diarrhoea:
  • may be severe enough to limit normal functioning
  • classically, the patient episodically passes one or two loose stools with an intervening diarrhoea-free period of 3-4 weeks
  • dumping syndromes
  • gallstones

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