Stapled transabdominal lower esophageal anastomosis without purse-string suture.

Because of anatomic limitations at the EG junction in total and subtotal gastric resections, gastrointestinal reconstruction is technically challenging. In stapled anastomosis, suboptimal application of a purse-string suture to the distal esophagus may lead to anastomotic breakdown. We describe herein a technique in which this step is eliminated to achieve a sound, full thickness anastomosis with the use of the Roticulator TA 30 and the EEA Premium stapling instruments.