An incision is made in the abdomen. A portion or all of the stomach (depending on the reason for the operation) is cut free from surrounding tissues, its blood supply is controlled and sewn shut, and then the stomach or part of it can be removed.

Depending on the type of operation, the intestine is then reconnected to the remaining stomach (in the case of a partial gastrectomy) or to the esophagus (in the case of a total gastrectomy).