ABSTRACT
PURPOSE: The purpose of this study is to describe a novel technique for thoracoscopic construction of an intrathoracic esophagogastrostomy using a circular stapler. DESCRIPTION: Conventional method for construction of the esophagogastric anastomosis requires placement of the anvil through an esophageal stump and securing it with a pursestring suture. Advances in stapler technology now permit the anvil to be placed transorally and positioned at the esophageal stump without the need for a pursestring suture. EVALUATION: Ten patients underwent laparoscopic and thoracoscopic esophagectomy with construction of an intrathoracic esophagogastric anastomosis using a circular stapler technique. The anvil was placed transorally in all patients without difficulty. There were no operative complications or postoperative leaks. CONCLUSIONS: The transoral placement of the anvil during thoracoscopic construction of an esophagogastrostomy is technically feasible and may facilitate the performance of the esophagogastric anastomosis using a circular stapler.
Subject(s)
Anastomosis, Surgical/methods , Esophagus/surgery , Stomach/surgery , Surgical Staplers , Thoracoscopy , Humans , Laparoscopy , Minimally Invasive Surgical Procedures/methodsABSTRACT
Minimally invasive esophagectomy is a feasible and safe alternative to open esophagectomy. The stomach is the preferred conduit for gastrointestinal reconstruction after esophagogastrectomy; however, if the stomach is not usable, the colon can be interposed as an alternative conduit. We describe the technique of minimally invasive Ivor Lewis esophagogastrectomy in a patient with a gastric cardia cancer involving the gastric body and distal esophagus. Laparoscopic colonic interposition using the right colon based on the middle colic vessels was used to restore gastrointestinal continuity.
