Closure techniques for esophageal reconstruction after total laryngectomy and their impact on fistula formation

Figure 1 Schematic illustration depicting hand-sewn and stapler-assisted techniques for esophageal closure following total laryngectomy. The upper panel shows the conventional manual suturing method, while the lower panel illustrates the use of a surgical stapler. The figure highlights the procedural differences between the two approaches in pharyngeal reconstruction.

Figure 2 Intraoperative images demonstrating the preparation of the esophagus for surgical stapler application following larynx removal. A and B: Intraoperative images showing the preparation of the esophageal mucosa following larynx removal for stapler application. Frontal view (A) and side view (B) of the esophageal mucosa grasped with forceps.

Figure 3 Intraoperative images demonstrating the application of a surgical stapler following total laryngectomy. Intraoperative images illustrating the application of a surgical stapler. A and B: The stapler is positioned on the esophageal mucosa (A), which is then (B) clamped to ensure precise closure; C: The final result shows two parallel rows of staples securing the sutured pharyngeal mucosa, indicating a well-aligned closure.