Thoracoscopic Construction of an Intrathoracic Esophagogastric Anastomosis Using a Circular Stapler: Transoral Placement of the Anvil

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.