Definition & Overview
The stomach is an organ in the abdominal area of the body. Its primary task is to store and digest food items. Like any other part of the body, it is prone to a number of disorders and diseases, even cancer. To confirm the exact problem, a doctor may need to perform a biopsy of the tissue from a specific area of the stomach.
A biopsy is a diagnostic procedure that involves obtaining a certain amount of tissue from an organ and analysing it in a laboratory. The results are then forwarded to the doctor to aid in making an accurate diagnosis and subsequently, formulating a treatment plan.
Today, most biopsies of the stomach are performed through a non-surgical method called endoscopy, or a minimally invasive surgical procedure called laparoscopy. In an endoscopy, a long tube fitted with a light source and a camera is inserted through the mouth and down into the stomach region. If the doctor needs to obtain tissue for a biopsy, a small surgical device is inserted through the tube.
A laparoscopy is similar in the sense that it uses miniature instruments. However, instead of inserting the tube through the throat, the surgeon will create a small incision in the abdominal area and insert the tube there.
In some cases, neither an endoscopy nor laparoscopy is applicable to perform the biopsy. If this happens, the best choice the doctor has is to perform laparotomy.
Laparotomy, which is also referred to as exploratory laparotomy, is a surgical procedure that involves creating a long incision in the abdomen. The surgeon will then expose the stomach to find the exact problem and obtain tissue for biopsy.
As much as possible, doctors try to avoid performing an exploratory laparotomy because it would mean a longer recovery time for the patient. The procedure is usually performed only if other forms of diagnostic procedures have failed to provide the information needed to make a diagnosis or if the patient is suffering from severe abdominal pain that requires immediate relief, but the doctor is unclear of the exact cause of the condition.
Who Should Undergo & Expected Results
As mentioned earlier, patients who will most likely require a biopsy of the stomach via laparotomy are those who have severe problems of the digestive system and have gone through less invasive procedures that have failed to provide the needed information for doctors to make a definitive diagnosis.
Laparotomy is also commonly performed in areas that lack the necessary equipment to perform a biopsy through endoscopy or laparoscopy. One of the most common scenarios wherein a biopsy of the stomach is performed through laparotomy is when the patient is suspected of having stomach cancer, gastritis, gastric cancer, and gastroesophageal reflux disease (GERD).
Diagnostic procedures for stomach cancer, or any type of cancer, usually include a biopsy. In most cases, or in areas that are equipped with minimally invasive surgical instruments, the biopsy will be performed using this method. If the hospital does not have the necessary equipment, then the surgeon may suggest laparotomy. The patient may choose to undergo such a procedure or opt to search for another hospital with the necessary equipment.
Due to the nature of laparotomy, which is essentially an open surgery, patients can expect a recovery period of up to 6 weeks or even longer depending on their condition.
How is the Procedure Performed?
If the doctor decides that a laparotomy is the best or the only method available to perform a biopsy of the stomach, the patient may need a few days to prepare for the procedure. However, if the biopsy is required due to an emergency, laparotomy can be performed immediately.
Prior to the procedure, the patient will be taken to the operating room and the area of the abdomen is prepared for surgery. An anaesthesiologist will administer a general anaesthetic so the patient will be unconscious throughout the surgery.
The surgeon will then create a single incision in the abdomen to expose the stomach. If needed, the surgeon may also cut open the stomach to examine the area and obtain tissue for a biopsy.
If possible, the surgeon may decide to perform treatment as well. For instance, if a tumour is detected, the surgeon can excise the tumour and submit it for a biopsy.
Once the required tissue has been obtained, the surgeon will close any open incisions with suture. The patient will then be monitored closely for signs of infections or complications.
Possible Risks and Complications
Unlike minimally invasive surgical procedures, open surgery has quite a number of risks and possibilities of complications. These include:
- Risk of damage to the stomach or other internal organs
- Risk of adverse reaction to the anaesthetic used
- Excessive bleeding (haemorrhage)
- Blocked bowel
- Pain in the abdomen
It is important to understand that a biopsy is considered a diagnostic procedure. It helps doctors to determine the exact cause of the problem and how it should be treated. As such, it is possible that the patient may require additional surgery.
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