Endoscopic Mucosal Resection (EMR)
Some patients may be eligible for nonsurgical removal of their tumor using Endoscopic Mucosal Resection (EMR). This is similar to upper endoscopy, in that the surgeon uses an endoscope, or long flexible tube with a small video camera attached, to view the area and identify the tumor. Next, small surgical tools are passed through the endoscope to remove the tumor and a small area surrounding it.
EMR for gastric cancer was developed in Japan where the disease is far more prevalent. Doctors at the Center for Global Excellence in Gastric Cancer Care were among the world’s leading experts in this approach.
A partial gastrectomy removes the portion of the stomach that is affected the cancer and may also take a part of the esophagus of the first section of the small intestine. Some of the omentum, a layer of fat tissue covering the stomach and intestines, may be removed as well, along with the nearby lymph nodes. Eating is much easier after surgery if only part of the stomach is removed instead of the entire stomach.
A total gastrectomy is performed if the cancer has spread throughout the stomach. Then the entire organ is removed along with the nearby lymph nodes, the omentum, and often part of the esophagus.
After this surgery, patients can only eat a small amount of food at a time. Because of this, they must eat more often. To address this problem, a tube may be placed to the intestine during surgery. One end is attached to the intestine while the other remains outside the body. This is called a jejunostomy tube or J tube and allows patient to receive liquid nutrition.
Traditionally both partial and total gastrectomies have done through a large incision (cut) in the skin of the abdomen. However, our experts have pioneered a new minimally invasive approach that may have fewer complications, and faster recovery time.
Minimally Invasive Robotic Surgery
With specialized training in robotic surgery for gastric cancer with the world's foremost experts, Dr. Yanghee Woo has brought robotically assisted gastrectomy and lymph node dissection to NYP/Columbia, where it is now a standard of care.
Instead of making a large abdominal incision, surgeons the use robotic technology to excise cancerous tissue. This approach allows for greater precision and control. It is particularly valuable in cases when the surgeon must operate near blood vessels. Dr. Woo has researched and published extensively on its benefits to patients.
Compared to open surgery, laparoscopic surgery benefits patients with decreased pain, fewer pulmonary complications, and a faster recovery.
More information can be found here.