Thoracoscopic construction of an intrathoracic esophagogastric anastomosis using a circular stapler: transoral placement of the anvil

Ann Thorac Surg. 2008 Sep;86(3):989-92. doi: 10.1016/j.athoracsur.2008.03.034.

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.

MeSH terms

  • Anastomosis, Surgical / methods*
  • Esophagus / surgery*
  • Humans
  • Laparoscopy
  • Minimally Invasive Surgical Procedures / methods
  • Stomach / surgery*
  • Surgical Staplers*
  • Thoracoscopy*