Laparoscopic retrosternal gastric pull-up for fistulized mediastinal mass

Figure 1 Coronal and axial computed tomography view of the partially calcified subcarinal mass surrounding the carina, the bronchi, and eroding into the esophagus (note the mediastinal air).

Figure 2 Intraoperative view of the gastric conduit after complete tubularization.

Figure 3 Dissection of the esophageal stump into the mediastinum.

Figure 4 A wide substernal tunnel is created under direct visualization immediately posterior to the xyphoid process.

Figure 5 Circular mechanical stapled anastomosis at the neck.

Figure 6 Esophagram demonstrating normal transit of contrast trough the anastomosis and prompt gastric emptying.