A double stapled technique for oesophago-enteric anastomosis

Figure 1 Transverse incision in anterior wall of oesophagus.

Figure 2 Transverse anterior oesophagotomy. Stapler head spike with attached needle inserted through oesophagotomy into proximal oesophagus.

Figure 3 Placement of a circular stapler head with spike and attached needle. Needle was used to puncture anterior oesophagus -2 cm above the oesophagotomy. The oesophagus was then cross- stapled between the needle puncture site & the oesophagotomy.

Figure 4 Suture used to drive head spike through oesophageal wall above transverse suture line.

Figure 5 Introduction of the circular stapler body into the lumen of efferent conduit.