Intracorporeal end-to-end esophagojejunostomy using a circular stapler

Excerpt

Various methods exist for esophagojejunostomy, with the use of a circular stapler being a common choice in open gastrectomy. On the other hand, linear staplers have become preferably used in laparoscopic/robotic gastrectomy [1]. Although the use of linear staplers has the advantages of better view and easier manipulation, it has the drawback of unnecessary esophageal/mediastinal dissection which possibly reduces the function of the lower esophageal sphincter [2]. When we adopt the standard end-to-side anastomosis with a circular stapler to overcome these issues in laparoscopic/robotic gastrectomy, it is associated with poor tissue visualization and the potential risk of tissue involvement. We have developed an innovative intracorporeal end-to-end esophagojejunostomy procedure in order to address these limitations. …