Double-stapling technique for transhiatal distal esophageal resection: feasibility test in a cadaver model.
OBJECTIVES
To assess the feasibility of a new surgical technique for the resection of the distal third of the esophagus and/or cardias for neoplasm.


METHODS
This surgical technique consists of two steps: For this purpose we built a stainless steel support bar for the anvil that is thinner than the freespace of a standard linear suturing stapler (TATM). The support bar holds up a push rod that can be adapted to the hooking-unhooking of the anvil.


RESULTS
We performed our new technique on five cadavers. We did not encounter any difficulty during the procedures. We tested the anastomosis with hydropneumatic assessment without recording any leaks. The esophago-enteric anastomosis was then opened without finding any mechanical defects related to the procedure.


CONCLUSION
It can often be very difficult to fashion a safe hand-sewn pouch or a purse string around the anvil of an EEATM during the resection of the distal third of the esophagus or the cardias by a trans-hiatal approach. Moreover, there is no standardized procedure to minimize anastomotic leak. To avoid these mechanical problems we designed this innovative procedure, which is considered to be reproducible without significant training.
['Gentilli|S|S|', 'Davoli|F|F|', 'Portigliotti|L|L|', 'Boldorini|R|R|', 'Casadio|C|C|', 'Garavoglia|M|M|']
D000368:Aged D000714:Anastomosis, Surgical D016629:Esophagectomy D004947:Esophagus D005240:Feasibility Studies D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D017792:Surgical Stapling
Transhiatal Esophagus Stapler Anastomoses Cancer