(a) The distal esophagus is mobilized to a length of 6 to 8 cm above the gastroesophageal junction.
(b)Two stay sutures of 3-0 silk are placed 15-20 mm apart in the midportion of the esophageal staple line. In preparation for the anastomosis, a 10 mm esophagotomy will be created in between the stay sutures by cutting out the three rows of staples.
(c)The lumen of the esophagus with whitish mucosa is demonstrated.
(d) To prevent false passage of the stapler anvil, the layers of the esophageal wall are sutured together. The two anastomotic stay sutures and the suture through the anterior wall layers are visible.