New procedure for purse-string suture in thoracoscopic esophagectomy with intrathoracic anastomosis

Excerpt

Misawa and colleagues are to be congratulated for their interesting article [3]. The authors may indeed have thought they were the first to describe this “new procedure,” but the reviewers may have known better. In a different setting (colon as opposed to esophagus), an identical hand-sewn purse-string suture technique using a T-needle was described in Surgical Endoscopy only 7 years earlier [1]. There were no leaks in either case series, which involved five patients [3] and 54 patients [1], respectively. However, this purse-string technique did take approximately 20 min [3]. The question remains whether inserting the anvil through the open end of the hollow organ, pushing its shaft out of a lateral stab wound (made with an ultrasonically activated device on the shaft’s tip), and stapling off the open end of the hollow organ (with a linear stapler) [2] would save time with no unfavorable impact on leak rates. …