{"key":"op_122_DE","page":{"url":"https://pl.bookimed.com/clinics/country=germany/procedure=gastrectomy/","procedure":{"id":122,"slug":"gastrectomy","name":"Operacja raka żołądka","name_forms":{"plural":{"status":"missing","reason":"not_collected"},"genitive":{"status":"missing","reason":"not_collected"}},"type":"surgery","grammar_number":{"status":"missing","reason":"not_collected"},"parent_id":"oncology","family_attribute":{"status":"missing","reason":"not_collected"}},"country":{"id":22,"iso":"DE","name":"Niemcy"},"currency":"USD","data_date":"2026-09-24"},"pages":{"clinics_url":"https://pl.bookimed.com/clinics/country=germany/procedure=gastrectomy/","cost_url":"https://pl.bookimed.com/clinics/country=germany/procedure=gastrectomy/cost/","best_url":{"status":"missing","reason":"template not live"}},"price":{"from":20000,"to":47000,"avg":{"value":21000,"method":"median","source":"clinics"},"us":{"from":55000,"to":98000},"uk":{"from":25000,"to":49000},"by_technique":{"status":"missing","reason":"not_collected"},"by_city":[{"city":"Brema","from":20000},{"city":"Frankfurt nad Menem","from":22000},{"city":"Hamburg","from":26500},{"city":"Düsseldorf -> Düsseldorf","from":24500},{"city":"Berlin","from":24000}],"per_unit":{"status":"missing","reason":"not_collected"},"factors":{"status":"missing","reason":"not_collected"},"tiers":{"status":"missing","reason":"no_offers"},"comparison":[{"country_iso":"UA","from":10000,"to":18000},{"country_iso":"FR","from":21000,"to":34000},{"country_iso":"GB","from":25000,"to":49000},{"country_iso":"US","from":55000,"to":98000},{"country_iso":"IL","from":28000,"to":45000},{"country_iso":"TR","from":8500,"to":21500},{"country_iso":"MX","from":14000,"to":23000},{"country_iso":"CA","from":38000,"to":68000},{"country_iso":"AE","from":22000,"to":38000},{"country_iso":"TH","from":11000,"to":20000},{"country_iso":"PL","from":9500,"to":15500},{"country_iso":"KR","from":19000,"to":23000},{"country_iso":"CZ","from":13000,"to":15500},{"country_iso":"AT","from":24000,"to":37000},{"country_iso":"ES","from":27000,"to":40000},{"country_iso":"IT","from":16000,"to":27000},{"country_iso":"CN","from":25000,"to":{"status":"missing","reason":"not_collected"}},{"country_iso":"AU","from":38000,"to":60000},{"country_iso":"IN","from":5800,"to":10500},{"country_iso":"MY","from":11000,"to":18000},{"country_iso":"VN","from":6500,"to":9500},{"country_iso":"BR","from":13000,"to":23000},{"country_iso":"RO","from":8300,"to":8500}],"base_country":"US","base_is_fallback":false},"savings":{"pct":64,"variant":">=15%"},"package":{"included":{"status":"missing","reason":"no_offers"},"excluded":{"status":"missing","reason":"no_offers"},"extra_charges":{"status":"missing","reason":"not_collected"}},"clinics":{"count":11,"items":[{"id":268,"name":"Medical Center in Solingen","city":"Solingen","rating":4.7,"reviews_count":69,"accreditations":["Best doctor for herniated disc treatment","German Cancer Society"],"rank":1,"has_procedure":true,"why_ranked":"The clinic is certified by the German Cancer Society and includes specialized departments for gastroenterology and oncology, ensuring expert care for stomach cancer patients. Doctors perform over 9,000 endoscopic interventions annually.","bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":286,"name":"St. Martinus-Krankenhaus Düsseldorf","city":"Dusseldorf","rating":4,"reviews_count":1,"accreditations":{"status":"missing","reason":"not_collected"},"rank":2,"has_procedure":true,"why_ranked":{"status":"missing","reason":"not_collected"},"bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":136,"name":"Nordwest Clinic (Krankenhaus)","city":"Frankfurt am Main","rating":4.5,"reviews_count":57,"accreditations":["TÜV AG Сompany Research & Investing Certificate","TOP German hospital according to 2019 Focus ranking","World's Best Hospitals 2021 by Newsweek"],"rank":3,"has_procedure":true,"why_ranked":"ESMO-certified oncology center with specialized surgical techniques. Doctors have performed 3,000+ intestinal surgeries, ensuring high expertise in gastrointestinal cancer treatment.","bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":29,"name":"Charité - Universitätsmedizin Berlin","city":"Berlin","rating":3.3,"reviews_count":3,"accreditations":["German Cancer Society","TOP German hospital according to 2019 Focus ranking","World's Best Hospitals 2021 by Newsweek","World's Best Hospitals 2022 by Newsweek","World's Best Smart Hospitals 2023 by Newsweek"],"rank":4,"has_procedure":true,"why_ranked":{"status":"missing","reason":"not_collected"},"bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":39,"name":"The University Hospital in Dusseldorf","city":"Dusseldorf","rating":{"status":"missing","reason":"not_collected"},"reviews_count":{"status":"missing","reason":"not_collected"},"accreditations":["World's Best Smart Hospitals 2023 by Newsweek"],"rank":5,"has_procedure":true,"why_ranked":{"status":"missing","reason":"not_collected"},"bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":109,"name":"Department of Urology at Dortmund Clinic","city":"Dortmund","rating":{"status":"missing","reason":"not_collected"},"reviews_count":{"status":"missing","reason":"not_collected"},"accreditations":{"status":"missing","reason":"not_collected"},"rank":6,"has_procedure":true,"why_ranked":{"status":"missing","reason":"not_collected"},"bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":269,"name":"Meoclinic Hospital","city":"Berlin","rating":4.7,"reviews_count":17,"accreditations":["International Organization for Standardization"],"rank":7,"has_procedure":true,"why_ranked":{"status":"missing","reason":"not_collected"},"bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":270,"name":"Essen University Hospital","city":"Essen","rating":{"status":"missing","reason":"not_collected"},"reviews_count":{"status":"missing","reason":"not_collected"},"accreditations":["World's Best Hospitals 2021 by Newsweek","World's Best Hospitals 2022 by Newsweek","World's Best Smart Hospitals 2023 by Newsweek"],"rank":8,"has_procedure":true,"why_ranked":{"status":"missing","reason":"not_collected"},"bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":295,"name":"Bremen-Mitte Clinic","city":"Bremen","rating":4.3,"reviews_count":41,"accreditations":["International Organization for Standardization","TOP German hospital according to 2019 Focus ranking","World's Best Hospitals 2021 by Newsweek"],"rank":9,"has_procedure":true,"why_ranked":{"status":"missing","reason":"not_collected"},"bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":404,"name":"Bremen-Ost Clinic","city":"Bremen","rating":{"status":"missing","reason":"not_collected"},"reviews_count":{"status":"missing","reason":"not_collected"},"accreditations":["Cooperation for transparency and quality in the health service","TOP German hospital according to 2019 Focus ranking"],"rank":10,"has_procedure":true,"why_ranked":{"status":"missing","reason":"not_collected"},"bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}},{"id":7769,"name":"Helios Gesundheit","city":"Wuppertal","rating":{"status":"missing","reason":"not_collected"},"reviews_count":{"status":"missing","reason":"not_collected"},"accreditations":["International Accreditation System for Interventional Oncology Services (IASIOS)","German Cancer Society","ISO 9001:2015 Quality management systems","Fellow, American College of Surgeons"],"rank":11,"has_procedure":true,"why_ranked":"Specialized in oncological visceral surgery with particular experience in stomach cancer, offering minimally invasive techniques and integrated psychooncological support.","bookimed_stats":{"status":"missing","reason":"not_published"},"procedure_description":{"status":"missing","reason":"not_collected"},"offers":{"status":"missing","reason":"no_offers"}}]},"doctors":{"count":4,"languages":{"status":"missing","reason":"not_collected"}},"cities":[{"id":352,"slug":"bremen","name":"Brema","clinics_count":2,"price_from":20000,"profile":{"city_type":"Hanseatic port city in northern Germany","access":["Bremen Airport (BRE), 4 km south of the city"],"sources":["https://en.wikipedia.org/wiki/Bremen","https://en.wikipedia.org/wiki/Bremen_Airport"],"checked_at":"2026-11-03","status":"ok"}},{"id":354,"slug":"frankfurt-am-main","name":"Frankfurt nad Menem","clinics_count":1,"price_from":22000,"profile":{"city_type":"Most populous city in Hesse, Germany","access":["Frankfurt Airport (FRA), 12 km from the city center"],"sources":["https://en.wikipedia.org/wiki/Frankfurt","https://en.wikipedia.org/wiki/Frankfurt_Airport"],"checked_at":"2026-11-03","status":"ok"}},{"id":119,"slug":"gamburg","name":"Hamburg","clinics_count":{"status":"missing","reason":"not_collected"},"price_from":26500,"profile":{"city_type":"Second-largest city in Germany","access":["Hamburg Airport (HAM), 9 km north of city center"],"sources":["https://en.wikipedia.org/wiki/Hamburg","https://en.wikipedia.org/wiki/Hamburg_Airport"],"checked_at":"2026-11-03","status":"ok"}},{"id":78,"slug":"dusseldorf","name":"Düsseldorf -> Düsseldorf","clinics_count":{"status":"missing","reason":"not_collected"},"price_from":24500,"profile":{"city_type":"Capital city of North Rhine-Westphalia, Germany","access":["Düsseldorf Airport (DUS), 7 km north of downtown"],"sources":["https://en.wikipedia.org/wiki/Düsseldorf","https://en.wikipedia.org/wiki/Düsseldorf_Airport"],"checked_at":"2026-11-03","status":"ok"}},{"id":23,"slug":"berlin","name":"Berlin","clinics_count":{"status":"missing","reason":"not_collected"},"price_from":24000,"profile":{"city_type":"Capital and largest city of Germany","access":["Berlin Airport (BER), 18 km from the city center"],"sources":["https://en.wikipedia.org/wiki/Berlin","https://en.wikipedia.org/wiki/Berlin_Brandenburg_Airport"],"checked_at":"2026-11-03","status":"ok"}}],"offers":{"active":{"status":"missing","reason":"no_offers"},"active_with_related":{"status":"missing","reason":"no_offers"},"hospital_nights_median":{"status":"missing","reason":"no_offers"},"days_in_country_median":{"status":"missing","reason":"no_offers"},"top_offers":{"status":"missing","reason":"no_offers"},"packages":{"status":"missing","reason":"no_offers"},"related_packages":{"status":"missing","reason":"no_offers"},"other_packages":{"status":"missing","reason":"no_offers"}},"medical":{"indications":["Resectable gastric adenocarcinoma","Early gastric cancer unsuitable for endoscopic resection","Selected palliative cases such as bleeding or obstruction"],"contraindications":["Distant metastases making curative resection impossible","Unacceptable cardiopulmonary or operative risk (relative; multidisciplinary assessment)","Uncorrectable severe coagulopathy","Locally unresectable invasion of critical structures"],"operation_hours":{"min":3,"max":6,"unit":"hours","qualifier":"Operative time for a single gastrectomy with lymphadenectomy and reconstruction."},"anesthesia":["general","regional"],"sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation; perioperative chemotherapy is separate and not included."},"stages":[{"code":"gastrectomy","label":"Partial or total gastrectomy with lymphadenectomy and reconstruction","after":{"min":0,"max":0,"unit":"days","qualifier":"Single operative session."}}],"qualifier":"Uncomplicated primary curative gastrectomy."},"hospital_nights":{"value":{"min":6,"max":10,"unit":"nights","qualifier":"Typical uncomplicated gastrectomy with enhanced recovery care; longer if complications or extended lymphadenectomy."},"source":"parsed_details"},"treatment_conditions":["inpatient"],"rehabilitation_days":{"min":28,"max":60,"unit":"days","qualifier":"Ordinary functional recovery after uncomplicated gastrectomy; dietary adaptation may continue longer."},"fly_home_after_days":{"min":9,"max":14,"unit":"days","qualifier":"Counted from surgery, after discharge and clearance; depends on thrombosis risk, oral intake, complications."},"back_to_work_days":{"min":28,"max":60,"unit":"days","qualifier":"After open or laparoscopic gastrectomy; desk work may resume sooner than physical work; adjuvant chemotherapy can delay return."},"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"Light walking early; heavy lifting and strenuous exercise after surgeon clearance, often after about 6 weeks or more."},"final_result_months":{"min":3,"max":12,"unit":"months","qualifier":"Digestion and weight stabilize over months; depends on resection extent (total vs distal) and adjuvant chemotherapy."},"result_longevity":"Anatomical changes are lifelong. Long-term outcome depends on cancer stage, margins and adjuvant therapy; recurrence is possible, so surveillance is needed for at least 5 years.","main_risks":["Anastomotic or duodenal stump leak","Infection, abscess, wound complications","Bleeding","Pneumonia and thromboembolism","Delayed gastric emptying","Dumping syndrome, reflux, weight loss and malnutrition","Vitamin B12 and iron deficiency (especially after total gastrectomy)","Anastomotic stricture"],"complication_rate_pct":{"min":15,"max":35,"unit":"percent","qualifier":"Any postoperative complication within 30-90 days; major leak, bleeding or abscess about 3-10%."},"revision_rate_pct":{"min":2,"max":6,"unit":"percent","qualifier":"Unplanned reoperation within 30-90 days, mainly for leak, bleeding or obstruction."},"success":{"metric":"5-year overall survival after curative gastrectomy","value":60,"horizon":"5 years","source":{"status":"missing","reason":"not_collected"},"evidence_status":"limited"},"scars":"Midline or upper abdominal incision scar after open surgery; several small port-site scars after laparoscopic or robotic surgery, plus a small extraction incision.","pain":"Moderate to significant postoperative pain for the first several days, managed with multimodal analgesia (epidural or regional blocks, oral/IV analgesics); less with laparoscopic approach.","preparation":["Staging (endoscopy with biopsy, CT, sometimes EUS or laparoscopy)","Multidisciplinary tumor board review","Nutritional assessment and optimization","Cardiopulmonary and anesthesia assessment","Smoking cessation and prehabilitation where possible","Fasting before surgery per anesthesia team instructions","Review of current medications with the care team"],"recovery_timeline":[{"phase":"Hospital stay (days 0-10)","description":"Early mobilization, gradual return to oral intake, monitoring for leaks and complications.","restrictions":["Progressive diet from liquids","No heavy lifting"]},{"phase":"Early home recovery (days 10-42)","description":"Small frequent meals, wound healing, fatigue improving; pathology review and adjuvant therapy planning.","restrictions":["No lifting over about 5 kg","Avoid strenuous activity"]},{"phase":"Late recovery (weeks 6-12)","description":"Gradual return to normal activity and diet adaptation; nutritional supplementation as needed.","restrictions":["Increase exercise gradually after surgeon clearance"]}],"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"First postoperative review, often with pathology results."}},{"purpose":"result_review","requirement":"routine","after":{"min":14,"max":35,"unit":"days","qualifier":"Pathology review and planning of adjuvant treatment if indicated."}},{"purpose":"assessment","requirement":"routine","after":{"min":90,"max":120,"unit":"days","qualifier":"Oncologic and nutritional surveillance; schedule varies by stage and protocol."}}],"sources":{"status":"missing","reason":"not_collected"},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask how many total gastrectomy operations the surgeon performs each year","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"How many total gastrectomy operations do you perform each year?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Ask the surgeon for their personal complication rate with this operation","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"What is your personal complication rate with this operation?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Ask whether the surgeon checks margins in the operating room to confirm all gastric tissue is removed","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Do you check margins in the operating room to confirm that all gastric tissue has been removed?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Ask whether the surgeon routinely places a feeding tube during this operation","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Do you routinely place a feeding tube during this operation?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Ask who will be responsible for your post-gastrectomy care if the surgeon is not your follow-up contact","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"If the surgeon will not be your primary point of contact for follow-up after surgery, make sure to ask who will be responsible for your post-gastrectomy care.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Ask whether you can speak with other patients who had this operation with the surgeon","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Can I speak to other patients who have had this operation with you?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C7","text":"Ask whether a registered dietitian is available before surgery","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Will I meet with a registered dietitian before surgery?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Surgeon avoids giving their own complication figures when asked about them","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Most surgeons keep track of their own complications, or their hospital likely does, and they will be forthcoming about their own outcomes and how they manage them.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"No dietitian meeting is offered before surgery, though it matters as much as after","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Meeting with a registered dietitian before surgery is as important as meeting with one after.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"The care team does not discuss what to expect before treatment starts","scope":"treatment_type","source":{"url":"https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq","host":"cancer.gov","quote":"Talking with your cancer care team before treatment begins about what to expect will be helpful.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F4","text":"Treatment plan is set without the patient and care team working together on it","scope":"treatment_type","source":{"url":"https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq","host":"cancer.gov","quote":"You and your cancer care team will work together to decide your treatment plan, which may include more than one type of treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Difficulty swallowing or food getting stuck","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"are having difficulty swallowing, or feel that food is getting stuck","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Losing weight quickly","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"are losing weight quickly","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W3","text":"Dizziness, faintness, or tummy cramps after eating","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"feel dizzy, faint, sick or have tummy cramps after you eat","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W4","text":"Heartburn that will not go away","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"have heartburn that will not go away","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1}},"parsed_details":{"procedure_type":"surgery","fields":{"anesthesia":["general","regional"],"back_to_work_days":{"min":28,"max":60,"unit":"days","qualifier":"After open or laparoscopic gastrectomy; desk work may resume sooner than physical work; adjuvant chemotherapy can delay return."},"complication_rate_pct":{"min":15,"max":35,"unit":"percent","qualifier":"Any postoperative complication within 30-90 days; major leak, bleeding or abscess about 3-10%."},"contraindications":["Distant metastases making curative resection impossible","Unacceptable cardiopulmonary or operative risk (relative; multidisciplinary assessment)","Uncorrectable severe coagulopathy","Locally unresectable invasion of critical structures"],"days_in_clinic":{"min":6,"max":10,"unit":"nights","qualifier":"Typical uncomplicated gastrectomy with enhanced recovery care; longer if complications or extended lymphadenectomy."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"Light walking early; heavy lifting and strenuous exercise after surgeon clearance, often after about 6 weeks or more."},"final_result_months":{"min":3,"max":12,"unit":"months","qualifier":"Digestion and weight stabilize over months; depends on resection extent (total vs distal) and adjuvant chemotherapy."},"fly_home_after_days":{"min":9,"max":14,"unit":"days","qualifier":"Counted from surgery, after discharge and clearance; depends on thrombosis risk, oral intake, complications."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"First postoperative review, often with pathology results."}},{"purpose":"result_review","requirement":"routine","after":{"min":14,"max":35,"unit":"days","qualifier":"Pathology review and planning of adjuvant treatment if indicated."}},{"purpose":"assessment","requirement":"routine","after":{"min":90,"max":120,"unit":"days","qualifier":"Oncologic and nutritional surveillance; schedule varies by stage and protocol."}}],"indications":["Resectable gastric adenocarcinoma","Early gastric cancer unsuitable for endoscopic resection","Selected palliative cases such as bleeding or obstruction"],"main_risks":["Anastomotic or duodenal stump leak","Infection, abscess, wound complications","Bleeding","Pneumonia and thromboembolism","Delayed gastric emptying","Dumping syndrome, reflux, weight loss and malnutrition","Vitamin B12 and iron deficiency (especially after total gastrectomy)","Anastomotic stricture"],"pain":"Moderate to significant postoperative pain for the first several days, managed with multimodal analgesia (epidural or regional blocks, oral/IV analgesics); less with laparoscopic approach.","preparation":["Staging (endoscopy with biopsy, CT, sometimes EUS or laparoscopy)","Multidisciplinary tumor board review","Nutritional assessment and optimization","Cardiopulmonary and anesthesia assessment","Smoking cessation and prehabilitation where possible","Fasting before surgery per anesthesia team instructions","Review of current medications with the care team"],"recovery_timeline":[{"phase":"Hospital stay (days 0-10)","description":"Early mobilization, gradual return to oral intake, monitoring for leaks and complications.","restrictions":["Progressive diet from liquids","No heavy lifting"]},{"phase":"Early home recovery (days 10-42)","description":"Small frequent meals, wound healing, fatigue improving; pathology review and adjuvant therapy planning.","restrictions":["No lifting over about 5 kg","Avoid strenuous activity"]},{"phase":"Late recovery (weeks 6-12)","description":"Gradual return to normal activity and diet adaptation; nutritional supplementation as needed.","restrictions":["Increase exercise gradually after surgeon clearance"]}],"rehabilitation_days":{"min":28,"max":60,"unit":"days","qualifier":"Ordinary functional recovery after uncomplicated gastrectomy; dietary adaptation may continue longer."},"result_longevity":"Anatomical changes are lifelong. Long-term outcome depends on cancer stage, margins and adjuvant therapy; recurrence is possible, so surveillance is needed for at least 5 years.","revision_rate_pct":{"min":2,"max":6,"unit":"percent","qualifier":"Unplanned reoperation within 30-90 days, mainly for leak, bleeding or obstruction."},"scars":"Midline or upper abdominal incision scar after open surgery; several small port-site scars after laparoscopic or robotic surgery, plus a small extraction incision.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation; perioperative chemotherapy is separate and not included."},"stages":[{"code":"gastrectomy","label":"Partial or total gastrectomy with lymphadenectomy and reconstruction","after":{"min":0,"max":0,"unit":"days","qualifier":"Single operative session."}}],"qualifier":"Uncomplicated primary curative gastrectomy."},"success":{"metric":"5-year overall survival after curative gastrectomy","value":60,"unit":"percent","horizon":"5 years","population":"Adults with resectable gastric adenocarcinoma, all stages combined, treated with curative intent","evidence_status":"limited"},"techniques":[{"name":"Total gastrectomy with Roux-en-Y reconstruction","suits_whom":"Patients with proximal or middle-stomach tumors or diffuse-type cancer.","recovery":"Longer recovery and greater nutritional impact."},{"name":"Distal (subtotal) gastrectomy","suits_whom":"Patients with distal tumors where an adequate margin allows a proximal remnant.","recovery":"Generally faster recovery with better nutrition than total gastrectomy."},{"name":"Laparoscopic or robotic gastrectomy","suits_whom":"Selected patients, particularly early or less advanced tumors, in experienced centers.","recovery":"Often shorter hospital stay and less pain than open surgery."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":3,"max":6,"unit":"hours","qualifier":"Operative time for a single gastrectomy with lymphadenectomy and reconstruction."},"initial_assessment_documents":["Gastroscopy report with biopsy pathology","Contrast-enhanced CT scan of chest and abdomen","Endoscopic ultrasound report (if available)","PET-CT report (if available)","Recent blood tests including hemoglobin and albumin","HER2 and MSI status report (if available)"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single operation; stay about 10-14 days including recovery before flight. Second trip only for surveillance or adjuvant care."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask how many total gastrectomy operations the surgeon performs each year","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"How many total gastrectomy operations do you perform each year?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Ask the surgeon for their personal complication rate with this operation","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"What is your personal complication rate with this operation?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Ask whether the surgeon checks margins in the operating room to confirm all gastric tissue is removed","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Do you check margins in the operating room to confirm that all gastric tissue has been removed?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Ask whether the surgeon routinely places a feeding tube during this operation","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Do you routinely place a feeding tube during this operation?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Ask who will be responsible for your post-gastrectomy care if the surgeon is not your follow-up contact","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"If the surgeon will not be your primary point of contact for follow-up after surgery, make sure to ask who will be responsible for your post-gastrectomy care.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Ask whether you can speak with other patients who had this operation with the surgeon","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Can I speak to other patients who have had this operation with you?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C7","text":"Ask whether a registered dietitian is available before surgery","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Will I meet with a registered dietitian before surgery?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Surgeon avoids giving their own complication figures when asked about them","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Most surgeons keep track of their own complications, or their hospital likely does, and they will be forthcoming about their own outcomes and how they manage them.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"No dietitian meeting is offered before surgery, though it matters as much as after","scope":"procedure","source":{"url":"https://ccr.cancer.gov/surgical-oncology-program/clinical-team/questions-to-ask-your-surgeon","host":"ccr.cancer.gov","quote":"Meeting with a registered dietitian before surgery is as important as meeting with one after.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"The care team does not discuss what to expect before treatment starts","scope":"treatment_type","source":{"url":"https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq","host":"cancer.gov","quote":"Talking with your cancer care team before treatment begins about what to expect will be helpful.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F4","text":"Treatment plan is set without the patient and care team working together on it","scope":"treatment_type","source":{"url":"https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq","host":"cancer.gov","quote":"You and your cancer care team will work together to decide your treatment plan, which may include more than one type of treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Difficulty swallowing or food getting stuck","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"are having difficulty swallowing, or feel that food is getting stuck","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Losing weight quickly","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"are losing weight quickly","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W3","text":"Dizziness, faintness, or tummy cramps after eating","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"feel dizzy, faint, sick or have tummy cramps after you eat","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W4","text":"Heartburn that will not go away","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"have heartburn that will not go away","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your cancer cannot be removed by surgery","name":"Chemotherapy","source":{"url":"https://www.nhs.uk/conditions/stomach-cancer/treatment/","host":"nhs.uk","quote":"before and after surgery to help make the cancer smaller after surgery to help stop the cancer coming back at the same time as other treatments to help make them more effective to help control and improve the symptoms of advanced cancer or if the cancer cannot be removed by surgery","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":37},{"id":"A2","text":"Your cancer is advanced and you need symptom control","name":"Radiotherapy","source":{"url":"https://www.nhs.uk/conditions/stomach-cancer/treatment/","host":"nhs.uk","quote":"with chemotherapy (chemoradiotherapy) to help stop the cancer coming back to help control and improve the symptoms for advanced cancer","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":140}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"total-gastrectomy","name":"Total gastrectomy with Roux-en-Y reconstruction","how_it_works":{"text":"All of the stomach is removed in this type of gastrectomy","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/how-its-done/","host":"nhs.uk","quote":"The type of gastrectomy you have will depend on whether all of your stomach needs to be removed (total gastrectomy) or only part of it (partial gastrectomy).","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":6,"max":8,"unit":"weeks","label":"6–8 weeks","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"It usually takes 6 to 8 weeks to heal from a gastrectomy and get back to your usual activities, but it can take up to a year to recover fully.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}},{"id":"distal-gastrectomy","name":"Distal (subtotal) gastrectomy","how_it_works":{"text":"Only part of the stomach is removed in this type of gastrectomy","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/how-its-done/","host":"nhs.uk","quote":"The type of gastrectomy you have will depend on whether all of your stomach needs to be removed (total gastrectomy) or only part of it (partial gastrectomy).","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":6,"max":8,"unit":"weeks","label":"6–8 weeks","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"It usually takes 6 to 8 weeks to heal from a gastrectomy and get back to your usual activities, but it can take up to a year to recover fully.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}},{"id":"laparoscopic","name":"Laparoscopic or robotic gastrectomy","how_it_works":{"text":"Small cuts are used in keyhole surgery instead of large open cuts","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/how-its-done/","host":"nhs.uk","quote":"The surgeon makes one or more cuts in your tummy or chest – these may be large cuts (open surgery) or small ones (keyhole surgery).","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1}}},"techniques":[{"id":"total-gastrectomy","name":"Total gastrectomy with Roux-en-Y reconstruction","how_it_works":{"id":"H1","text":"All of the stomach is removed in this type of gastrectomy","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/how-its-done/","host":"nhs.uk","quote":"The type of gastrectomy you have will depend on whether all of your stomach needs to be removed (total gastrectomy) or only part of it (partial gastrectomy).","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":6,"max":8,"unit":"weeks","label":"6–8 weeks","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"It usually takes 6 to 8 weeks to heal from a gastrectomy and get back to your usual activities, but it can take up to a year to recover fully.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"suits_whom":"Patients with proximal or middle-stomach tumors or diffuse-type cancer.","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Longer recovery and greater nutritional impact."},{"id":"distal-gastrectomy","name":"Distal (subtotal) gastrectomy","how_it_works":{"id":"H1","text":"Only part of the stomach is removed in this type of gastrectomy","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/how-its-done/","host":"nhs.uk","quote":"The type of gastrectomy you have will depend on whether all of your stomach needs to be removed (total gastrectomy) or only part of it (partial gastrectomy).","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":6,"max":8,"unit":"weeks","label":"6–8 weeks","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/recovery/","host":"nhs.uk","quote":"It usually takes 6 to 8 weeks to heal from a gastrectomy and get back to your usual activities, but it can take up to a year to recover fully.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"suits_whom":"Patients with distal tumors where an adequate margin allows a proximal remnant.","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Generally faster recovery with better nutrition than total gastrectomy."},{"id":"laparoscopic","name":"Laparoscopic or robotic gastrectomy","how_it_works":{"id":"H1","text":"Small cuts are used in keyhole surgery instead of large open cuts","source":{"url":"https://www.nhs.uk/tests-and-treatments/gastrectomy/how-its-done/","host":"nhs.uk","quote":"The surgeon makes one or more cuts in your tummy or chest – these may be large cuts (open surgery) or small ones (keyhole surgery).","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"},"suits_whom":"Selected patients, particularly early or less advanced tumors, in experienced centers.","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Often shorter hospital stay and less pain than open surgery."}],"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your cancer cannot be removed by surgery","name":"Chemotherapy","source":{"url":"https://www.nhs.uk/conditions/stomach-cancer/treatment/","host":"nhs.uk","quote":"before and after surgery to help make the cancer smaller after surgery to help stop the cancer coming back at the same time as other treatments to help make them more effective to help control and improve the symptoms of advanced cancer or if the cancer cannot be removed by surgery","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":37},{"id":"A2","text":"Your cancer is advanced and you need symptom control","name":"Radiotherapy","source":{"url":"https://www.nhs.uk/conditions/stomach-cancer/treatment/","host":"nhs.uk","quote":"with chemotherapy (chemoradiotherapy) to help stop the cancer coming back to help control and improve the symptoms for advanced cancer","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":140}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"diagnostic":{"status":"not_applicable"},"country":{"why":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-11","next_check_at":"2027-02-09"},"travel":{"status":"ok","items":[{"id":"V1","item":"visa","audience":"uk","volatile":true,"text":"British passport holders can travel to the Schengen area, which includes Germany, without a visa for up to 90 days in any 180-day period","source":{"url":"https://www.gov.uk/foreign-travel-advice/germany/entry-requirements","host":"gov.uk","quote":"You can travel without a visa to the Schengen area , which includes Germany, for up to 90 days in any 180-day period.","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}},{"id":"V2","item":"passport_validity","audience":"uk","volatile":true,"text":"A UK passport must have an expiry date at least 3 months after the day you plan to leave the Schengen area","source":{"url":"https://www.gov.uk/foreign-travel-advice/germany/entry-requirements","host":"gov.uk","quote":"have an ‘expiry date’ at least 3 months after the day you plan to leave the Schengen area (the expiry date does not need to be within 10 years of the date of issue)","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}},{"id":"V3","item":"passport_validity","audience":"us","volatile":true,"text":"A US passport should be valid for at least 3 months beyond your period of stay when transiting a Schengen country","source":{"url":"https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/Germany.html","host":"travel.state.gov","quote":"Your passport should be valid for at least 3 months beyond your period of stay if you plan on transiting a Schengen country.","tier":"official_travel","fetched_at":"2026-11-11","http_status":403}},{"id":"V4","item":"medicines","audience":"all","volatile":false,"text":"For medications Germany classifies as narcotics, you may only carry a 30-day supply","source":{"url":"https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/Germany.html","host":"travel.state.gov","quote":"For medications that Germany classifies as narcotics, you may only carry a 30-day supply.","tier":"official_travel","fetched_at":"2026-11-11","http_status":403}},{"id":"V5","item":"ghic","audience":"uk","volatile":false,"text":"To get medically necessary state healthcare in Germany, UK travelers need a GHIC or an EHIC","source":{"url":"https://www.gov.uk/foreign-travel-advice/germany/health","host":"gov.uk","quote":"To get medically necessary state healthcare in Germany, you need a Global Health Insurance Card ( GHIC ) or a European Health Insurance Card ( EHIC ).","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}},{"id":"V6","item":"emergency_number","audience":"all","volatile":false,"text":"Dial 112 and ask for an ambulance in Germany","source":{"url":"https://www.gov.uk/foreign-travel-advice/germany/health","host":"gov.uk","quote":"Dial 112 and ask for an ambulance.","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2026-12-11","version":1},"other_countries_with_page":["austria","azerbaijan","china","czech-republic","dominican-republic","egypt","greece","india","israel","italy","malaysia","mexico","poland","republic-of-korea","romania","spain","switzerland","thailand","turkey","ukraine","united-kingdom","united-states"]},"often_combined_with":{"status":"missing","reason":"not_collected"},"reviews":{"avg_rating":4.53,"count":188,"scope":"clinic","rating_scale":5,"pros":{"status":"missing","reason":"not_collected"},"cons":{"status":"missing","reason":"not_collected"}},"current":{"seo_text":"<p>The cost of stomach cancer surgery in Germany typically ranges <strong>from _price_from_ to _price_to_</strong>. Prices vary depending on the hospital, the surgeon’s experience, the type of surgery (partial or total gastrectomy), and whether minimally invasive or open techniques are used. In the United States, the average cost is <strong>_price_compare_us_average_</strong> (per ACS). Stomach cancer surgery in Germany is about _price_percent_discount_% less than in the U.S.</p>\n\n<p>German hospitals usually include pre-op diagnostics, the surgery itself, anesthesia, hospital stay (5–14 days), pathology, post-op care, and follow-up visits. In the U.S., many costs—such as anesthesia, pathology, and inpatient care—are billed separately from the surgeon’s fee. Always confirm what’s included at each clinic.</p>","faq":[{"q":"What are the primary surgical options for stomach cancer in Germany?","a":"<p>Surgical options for stomach cancer in Germany focus on R0 resection, ensuring complete tumor removal with clear margins. Specialists utilize endoscopic techniques for early stages and radical gastrectomies for invasive cases. These procedures are integrated into multimodal therapy plans often including systematic D2 lymphadenectomy and robotic-assisted technology.</p> <ul> <li><strong>Endoscopic resection:</strong> Micro-surgeries like EMR and ESD remove superficial mucosal lesions without external incisions.</li> <li><strong>Partial gastrectomy:</strong> Surgeons remove the lower stomach portion when tumors are located distally.</li> <li><strong>Total gastrectomy:</strong> Complete organ removal for upper-stomach tumors, followed by Roux-en-Y esophageal reconstruction.</li> <li><strong>D2 lymphadenectomy:</strong> Mandatory removal of at least 25 lymph nodes to prevent regional relapse.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> German surgical excellence is driven by clinical volume. At Nordwest Clinic, Prof. Dr. Thomas W. Kraus has performed over 3,000 procedures. This high-volume experience directly correlates with the ability to perform organ-preserving partial gastrectomies where less experienced centers might default to total removal. Seeking centers with over 60,000 annual patients, like Solingen Medical Center, ensures access to these refined surgical outcomes.</p> <p><strong>Patient Consensus:</strong> Patients emphasize that while total gastrectomy is life-altering, specialized German centers excel at multidisciplinary planning. Many highlight the importance of pursuing second opinions for potential organ-sparing options before committing to full stomach removal.</p>"},{"q":"How do German clinics handle advanced or stage 4 stomach cancer?","a":"<p>German clinics manage stage 4 stomach cancer through biomarker-driven multimodal protocols. Specialized centers combine systemic immunotherapy and targeted drugs with regional therapies like HIPEC or PIPAC. Multidisciplinary tumor boards at certified cancer centers coordinate these aggressive strategies to extend survival and prioritize patient quality of life.</p> <ul> <li><strong>Biomarker profiling:</strong> German S3-guidelines mandate testing for HER2, PD-L1, and Claudin 18.2 markers.</li> <li><strong>Advanced delivery:</strong> Clinics use pressurized aerosol chemotherapy (PIPAC) for widespread peritoneal metastasis.</li> <li><strong>Innovative vaccines:</strong> Centers like Nordwest Clinic offer anticancer vaccines within personalized targeted therapy plans.</li> <li><strong>Palliative surgery:</strong> Surgeons perform gastroenterostomy or stent placement to resolve tumor-related gastric blockages.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> German clinics like Nordwest or Solingen prioritize systemic therapy before considering any surgical intervention. Data shows that German surgeons often perform specialized omentectomy or gastroenterostomy only after 3-4 cycles of chemotherapy have stabilized the tumor. This sequential approach ensures patients are strong enough for surgery, reducing recovery time to approximately 10–14 days in the hospital.</p> <p><strong>Patient Consensus:</strong> Patients value the structured protocols but note that treatment often starts with conservative therapy rather than immediate surgery. Emotional support and specialized nutritional planning are consistently mentioned as vital parts of the care experience.</p>"},{"q":"What is the success rate of stomach cancer surgery in Germany?","a":"<p>Stomach cancer surgery in Germany achieves an efficiency rate of 85% to 90% for early-stage localized tumors. The success of treatment relies on curative R0 resections in specialized centers certified by the German Cancer Society, offering 5-year survival rates reaching 75.8% for early diagnosis.</p> <ul> <li><strong>Success by stage:</strong> Early localized cancer surgery achieves 75.8% 5-year survival in specialized clinics.</li> <li><strong>Curative resection:</strong> Successful R0 resections with clean margins show 51.2% to 56% survival rates.</li> <li><strong>Specialized credentials:</strong> Top facilities like Medical Center in Solingen hold German Cancer Society certifications.</li> <li><strong>Surgical expertise:</strong> Surgeons like Prof. Thomas W Kraus have performed over 3,000 successful interventions.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> German surgical success is driven by high-volume centers rather than general hospitals. Data shows clinics like Medical Center in Solingen and Nordwest Clinic treat over 60,000 patients annually. This volume allows surgeons to master D2 lymph node clearance. This technique significantly reduces regional relapses compared to standard procedures.</p> <p><strong>Patient Consensus:</strong> Patients emphasize that surgical success depends largely on achieving R0 resection with clean margins. Many suggest choosing university hospitals to better manage long-term recovery challenges like dumping syndrome and fatigue.</p>"},{"q":"How is the quality of surgical care regulated in Germany?","a":"<p>Surgical care in Germany is regulated through a mandatory corporatist model overseen by the Federal Joint Committee (G-BA). This body enforces strict structural, process, and outcome metrics, requiring hospital surgeons to complete 250 continuing medical education points every 5 years to maintain their qualifications.</p> <ul> <li><strong>Minimum volume standards:</strong> Hospitals must perform a specific number of procedures annually to receive medical reimbursement.</li> <li><strong>Mandatory quality reports:</strong> Over 2,000 hospitals must publish annual data on complication rates and hygiene standards.</li> <li><strong>Specialist center certification:</strong> The German Cancer Society (DKG) audits centers for adherence to strict oncology protocols.</li> <li><strong>Research monitoring:</strong> The IQTIG and IQWiG institutes design metrics to evaluate surgical safety and effectiveness.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> German surgical quality is tied to institution volume rather than individual prestige. Bookimed data shows that top-rated centers like Essen University Hospital and Charité handle over 370,000 and 845,000 patients annually. Choosing these high-volume university clinics ensures access to multidisciplinary tumor boards and the latest research-led surgical techniques.</p> <p><strong>Patient Consensus:</strong> Success in complex cancer surgeries depends on finding a high-volume center with a dedicated tumor board. Patients emphasize that having ICU, pathology, and oncology support on-site is more important than a specific surgeon name.</p>"},{"q":"Which German hospitals are highly recognized for gastric cancer surgery?","a":"<p>German university hospitals and specialized centers certified by the German Cancer Society are premier choices for gastric cancer surgery. Highly recognized institutions include Charite Universitätsmedizin Berlin, Nordwest Clinic, and University Hospital Düsseldorf. These facilities utilize multidisciplinary tumor boards, robot-assisted DaVinci systems, and advanced Hyperthermic Intraperitoneal Chemotherapy.</p> <ul> <li><strong>Charite Berlin:</strong> Europe’s largest university hospital using precision molecular research for complex gastric surgical planning.</li> <li><strong>Nordwest Clinic:</strong> An ESMO-certified center in Frankfurt featuring surgeons with over 3,000 gastrointestinal procedures.</li> <li><strong>Medical Center Solingen:</strong> A top-rated Focus magazine clinic housing a dedicated, certified interdisciplinary cancer center.</li> <li><strong>Nordrhein-Westfalen Complex:</strong> A massive five-hospital network treating 45,000 inpatients annually with advanced robotic surgery.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> While many search for the newest technology, Germany’s legal high-volume thresholds are the real safety net. Hospitals like Nordwest Clinic or Nordrhein-Westfalen often handle 45,000 to 60,000 patients annually. This high frequency ensures surgical teams maintain peak proficiency in complex reconstructions and lymph node dissections.</p> <p><strong>Patient Consensus:</strong> Patients emphasize choosing dedicated gastrointestinal oncology units over smaller local hospitals for complex cases. They recommend specifically asking about the surgeon’s annual volume for reconstructive options after stomach removal.</p>"},{"q":"How long must an international patient stay in Germany for surgery?","a":"<p>International patients undergoing stomach cancer surgery in Germany generally require a total stay of 21 to 35 days. This timeframe covers pre-operative assessments, a 7 to 14-day inpatient hospital period, and a mandatory 14-day post-operative recovery window to ensure you are cleared to fly safely.</p> <ul> <li><strong>Inpatient hospital stay:</strong> Patients remain hospitalized for 7–14 days for monitoring after radical tumor resection.</li> <li><strong>Post-operative recovery:</strong> A 14-day minimum ground stay is required to prevent deep vein thrombosis.</li> <li><strong>Medical clearance:</strong> Surgeons must issue a Fit to Fly certificate before patients board international flights.</li> <li><strong>Visa requirements:</strong> Most oncology treatments fit within the 90-day Schengen Type C medical visa.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Germany’s oncology infrastructure is highly concentrated in North Rhine-Westphalia, where clinics like Nordwest and Solingen handle over 60,000 patients annually. While surgery costs start from _op_122_price_from_, patients often save _price_percent_discount_% compared to US averages, even when factoring in the required 3-week hotel stay for recovery.</p>"},{"q":"Which hospitals in Germany are top-rated for neurosurgery?","a":"<p>Germany features some of the worlds most prestigious neurosurgery departments, led by Charité – Universitätsmedizin Berlin and University Hospital Heidelberg. These centers excel in treating complex brain tumors and cerebrovascular disorders. They utilize advanced technologies like intraoperative MRI and computer-assisted neuronavigation to maximize procedural success.</p> <ul> <li><strong>Charité Berlin:</strong> Performs 5,000+ surgeries annually. Led by renowned neurosurgeon Dr. Peter Vajkoczy.</li> <li><strong>Medical Center Solingen:</strong> Dr. Ralf Buhl has performed 4,000+ procedures, including minimally invasive spine surgery.</li> <li><strong>Asklepios Nord Clinic:</strong> Features Germany's only two-sided intraoperative MRI for real-time surgical precision during tumor removals.</li> <li><strong>Nordwest Clinic:</strong> Recognized by Newsweek as a leading hospital for innovations in 3D ultrasound technology.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Data shows that choosing high-volume centers often leads to more conservative treatment recommendations. At Medical Center Solingen, which treats 60,000+ patients yearly, surgeons frequently suggest physiotherapy over immediate surgery if risks appear high. This volume-based expertise ensures patients only undergo operations when statistically necessary for recovery.</p> <p><strong>Patient Consensus:</strong> Patients note that German specialists are very cautious and will explain all risks before proceeding. Many emphasize the comfort of modern facilities, though some mention that having a translator is helpful for navigating administrative paperwork.</p>"},{"q":"What are the reported success rates for high-complexity neurosurgery in Germany?","a":"<p>High-complexity neurosurgery in Germany demonstrates exceptional safety. Spinal fusions reach a 99% success rate. Primary brain tumor resections maintain a 97% survival rate. Functional independence is high. Over 82% of patients discharge directly home after treatment. German centers prioritize preserving neurological function using advanced mapping.</p> <ul> <li><strong>Tumor resection:</strong> Surgeons achieve gross total resection in 87.2% of brain metastasis cases.</li> <li><strong>Vascular success:</strong> Unruptured aneurysm treatments show a 98.7% survival rate in German hospitals.</li> <li><strong>Neurological improvement:</strong> Nearly 43% of patients see functional score gains after complex resections.</li> <li><strong>Surgical safety:</strong> Spinal procedures maintain a 98–99% survival rate across major surgical centers.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> High-volume surgeons like Dr. Uwe Kehler at Asklepios Altona Clinic perform 2,000+ operations annually. Data shows these experts maintain success rates up to 90% for the most complex cerebral tumors. Choosing a specialist with 4,000+ personal surgeries, such as Dr. Ralf Buhl, ensures technical precision gathered over decades of practice.</p> <p><strong>Patient Consensus:</strong> Patients note that German surgeons often prioritize physical function over aggressive tumor removal. It is important to write down all questions in advance to make the most of short consultations with busy professors.</p>"},{"q":"What advanced technologies are routinely available in German neurosurgical clinics?","a":"<p>German neurosurgical clinics routinely integrate high-precision digital tools and real-time imaging into surgical practice. Core technologies include computer-assisted neuronavigation for brain and spinal procedures. Facilities like Asklepios Nord Clinic use intraoperative MRI to verify tumor removal in real time. These systems provide a 3D GPS for surgeons.</p> <ul> <li><strong>Neuronavigation:</strong> Provides 3D visualization and real-time instrument tracking for sub-millimeter surgical precision.</li> <li><strong>Intraoperative imaging:</strong> Systems like iMRI and O-arm CT allow immediate verification of successful resection.</li> <li><strong>Neuromonitoring:</strong> Tracks motor and sensory functions during surgery to protect the nervous system.</li> <li><strong>Fluorescence diagnostics:</strong> Uses 5-ALA dye to illuminate tumor borders for more complete removal.</li> <li><strong>Robotic assistance:</strong> Systems like Da Vinci enhance dexterity for complex minimally invasive procedures.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> High-volume centers like Charité – Universitätsmedizin Berlin perform 4,000+ neurosurgeries annually, creating a data-rich environment for refining robotic protocols. Medical Center in Solingen offers specialized packages for herniated disc surgery including preoperative diagnostics. This volume allows German clinics to negotiate better rates for consumables, keeping advanced tech accessible.</p> <p><strong>Patient Consensus:</strong> Patients note that modern German clinics significantly reduce recovery times compared to older surgical methods. Many describe the experience as less painful due to smaller incisions and highly competent staff who explain every technical risk clearly.</p>"},{"q":"What specialist training do practicing neurosurgeons in Germany complete?","a":"<p>Neurosurgeons in Germany must complete 6 years of specialized residency training after medical school. This structured program includes intensive care, clinical practice, and a mandatory surgical log. Candidates then pass a state board exam to earn the title Facharzt für Neurochirurgie.</p> <ul> <li><strong>Clinical residency:</strong> Requires 48 to 72 months of dedicated neurosurgical practice.</li> <li><strong>Intensive care:</strong> Includes mandatory 6-month rotation in a neurosurgical intensive care unit.</li> <li><strong>Surgical log:</strong> Surgeons document hundreds of procedures, including craniotomies and spinal surgeries.</li> <li><strong>Board examination:</strong> Candidates must pass a state-administered oral and practical medical assessment.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> German neurosurgery training emphasizes high-volume surgical experience. For example, Dr. Ralf Buhl at Medical Center in Solingen has performed 4,000+ surgeries. Dr. Jürgen Kiwit at Meoclinic Hospital brings 25+ years of expertise. This rigorous system ensures that specialists at major centers manage complex cases with proven precision.</p> <p><strong>Patient Consensus:</strong> Patients feel confident knowing their doctors underwent years of strict, state-monitored training. Many note that the detailed documentation of a surgeon's past procedures provides significant peace of mind before surgery.</p>"},{"q":"What language and licensure requirements apply to international surgeons aiming to train or observe neurosurgery cases in Germany?","a":"<p>International neurosurgeons must meet strict language and licensure standards to train or observe in Germany. Training requires a full medical license or temporary permit. Observers need hospital-specific approval. Both paths demand high-level German proficiency to participate in clinical discussions and follow complex surgical protocols safely.</p> <ul> <li><strong>Language proficiency:</strong> General German B2 and medical C1 (Fachsprachprüfung) are mandatory for clinical training.</li> <li><strong>Clinical licensure:</strong> Surgeons need Approbation for permanent practice or Berufserlaubnis for temporary supervised training.</li> <li><strong>Observation status:</strong> A Hospitation allows observing surgeries without medical responsibility or a formal license.</li> <li><strong>Credential evaluation:</strong> Non-EU graduates often face a 3–6 month process to verify their medical degrees.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> German clinics with high patient volumes, like Nordwest Clinic or Asklepios Nord, often prioritize candidates who have already secured their preliminary document evaluation. Our data shows that professors like Dr. Uwe Kehler and Dr. Paul Kremer manage thousands of cases annually. Demonstrating German B2 level early can bypass many bureaucratic delays in these busy departments.</p> <p><strong>Patient Consensus:</strong> Patients note that the language barrier is significant. They emphasize that while some international staff help, having a translator or a German-speaking doctor is vital for clear communication.</p>"},{"q":"Does Germany have enough neurosurgeons to handle both domestic and international patient volumes?","a":"<p>Germany maintains the highest density of neurosurgeons in Europe with 2.94 specialists per 100,000 residents. This robust workforce easily manages international volumes through 184 dedicated departments. Key facilities like Charite Berlin perform 4,000+ surgeries annually. High specialist availability ensures additional capacity for complex global cases.</p> <ul> <li><strong>Specialist density:</strong> Germany has 2.94 neurosurgeons per 100,000 people, doubling the European average.</li> <li><strong>Clinical infrastructure:</strong> Over 182 dedicated neurosurgical departments provide widespread geographic access across Germany.</li> <li><strong>Surgical expertise:</strong> Prof. Dr. Peter Vajkoczy at Charite Berlin leads over 4,000 annual procedures.</li> <li><strong>Advanced technology:</strong> Facilities like Asklepios Nord Clinic utilize intraoperative MRI and computerized neuronavigation.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> While Germany has high specialist numbers, top-tier professors like Dr. Ralf Buhl or Dr. Uwe Kehler are often concentrated in major hubs like Hamburg or Solingen. Our data shows these high-volume centers actually offer faster access for international patients than smaller clinics. Large academic hospitals maintain dedicated tracks for complex cases, effectively bypassing local capacity bottlenecks found in rural areas.</p> <p><strong>Patient Consensus:</strong> Patients often note that while surgeons are highly professional, clear communication about reports can sometimes take time. One patient mentioned that recovery periods in German clinics are now much shorter and less painful than in previous decades.</p>"}],"h2":[{"text":"Jak to działa","kind":"content"},{"text":"Jaka jest cena operacji raka żołądka w Niemczech? Proszę dowiedzieć się teraz","kind":"content"},{"text":"Dowiedzieć się o najlepszych klinikach w operacji raka żołądka w Niemczech: 11 sprawdzonych klinik i ceny","kind":"content"},{"text":"Przegląd procedury Operacja raka żołądka w Niemczech","kind":"content"},{"text":"Proszę uzyskać konsultację medyczną dotyczącą operacji raka żołądka w Niemczech: Proszę wybierać spośród najlepszych specjalistów w tej dziedzinie","kind":"content"},{"text":"Wideo historie pacjentów Bookimed","kind":"content"},{"text":"Opinie o Bookimed: poznać prawdziwe doświadczenia pacjentów","kind":"content"},{"text":"Udostępnić tę treść","kind":"content"},{"text":"FAQ dotyczące operacji raka żołądka w Niemczech","kind":"content"},{"text":"Uzyskać bezpłatną konsultację","kind":"content"}]},"placeholders":{"price_from":"{{price_from}}","clinics_count":"{{clinics_count}}","cities_count":"{{cities_count}}","savings_pct":"{{savings_pct}}","data_date":"{{data_date}}"},"legal":{"restricted_markets":{"status":"missing","reason":"not_collected"}},"conflicts":[]}