Novel T-Shaped Linear-Stapled Intrathoracic Esophagogastric Anastomosis for Minimally Invasive Ivor Lewis Esophagectomy

We report a novel T-shaped linear-stapled intrathoracic esophagogastric anastomosis for minimally invasive Ivor Lewis esophagectomy. A unique feature of this technique is a “gastric pouch” that is preserved proximal to the gastric conduit and which serves as the stapler-firing pathway to protect the gastric conduit. The linear stapler is placed through an auxiliary port in the seventh intercostal space on the right posterior axillary line and fired along the longitudinal axis of the thorax, without being constrained by limited intrathoracic space. This technique, which has been performed in 8 patients, is efficient, reliable, and easy to perform.