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. 2016 Mar 9;3:16. doi: 10.3389/fsurg.2016.00016

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Copyright © 2016 Antonakis, Köckerling and Kallinowski.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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A hiatoplasty is formed with three evenly spaced non-absorbable sutures (Ethibond 0, Ethicon, Norderstedt, Germany, arrows). The distal esophagus is encircled with a silastic band and held to the left. At this point of time, a 54-Ch Rüsch tube is passed through the esophagogastric junction and a 5-mm instrument is additionally placed from the left into the newly formed hiatus in order to ensure sufficient space for the passage of food. A similar instrument is placed at the low left corner of the picture for comparison of sizes. Another 5-mm instrument is inserted from the right in order to lift the ventral crural junction to facilitate instrumentation.