VA01.7. New Connections: True Stapled End-to-End Anastomosis for Esophagectomy

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ID: 325978
2026
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Ranked #193 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – technique Video Description The most common esophageal anastomotic technique involves an end to side anastomosis with the stapler deploying along the greater curvature, technically disrupting the distal conduit blood supply. In this video, we demonstrate a novel technique for creation of a true end-to-end stapled anastomosis (EEA). During the abdominal phase of esophagectomy, our standard is to create a 3 cm gastric conduit. In this technique, a wider (4.5 cm) area is created at the lesser curve at the mid-point of the conduit. This widened area serves as the location where the EEA stapler will be introduced when creating the anastomosis. After transitioning to the thoracic cavity and specimen removal, we insert and secure the anvil into the proximal esophagus. The conduit is truncated to create the true end. The conduit is incised on the staple line at the widened portion, and the EEA stapler is introduced. The stapler is advanced to the true end and the anastomosis is created. The stapler, donut rings, and anvil are all removed through the incision in the conduit. Finally, the opening is sutured closed for retraction and is subsequently re-stapled to the standard 3 cm final neoesophagus width. By placing the anastomosis at the true end, the gastroepiploic arcade is allowed to maintain its course to the most distal portion of the conduit. Since its implementation, over 40 patients have undergone esophagectomy with this anastomotic technique with no increased morbidity. As we continue to optimize this approach, further studies will establish its utility in esophagectomy.
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Authors Marissa Matto, James Luketich, Christian Otero, Evan Alicuben
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.436
URL
https://academic.oup.com/dote/article-pdf/39/Supplement_1/doag077.436/70760393/doag077.436.pdf
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