Fig. 2. Anvil fixation technique. (A) After incising 3/4 of the esophageal wall, a laparoscopic hand-sewn purse-string suturing was performed. (B) An anvil rim was introduced into the esophageal lumen by sliding on the posterior wall of the esophagus. (C) The purse-string suturing was ligated. (D) Kelly forceps were passed through the posterior wall of the esophagus to grasp the ligated thread. (E) The ligated thread was turned through the posterior wall of the esophagus. (F) The turned thread was ligated again. (G) The remnant esophageal wall was incised. (H) The anvil fixation was completed.
