Reliable cervical anastomosis through the retrosternal route with stepwise gastric tube Yoshifumi Ikeda, MD, Shoichi Tobari, MD, Masanori Niimi, MD, PhD,

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Presentation transcript:

Reliable cervical anastomosis through the retrosternal route with stepwise gastric tube Yoshifumi Ikeda, MD, Shoichi Tobari, MD, Masanori Niimi, MD, PhD, Shigenao Kan, MD, Hiroshi Takami, MD, Susumu Kodaira, MD The Journal of Thoracic and Cardiovascular Surgery Volume 125, Issue 6, Pages 1306-1312 (June 2003) DOI: 10.1016/S0022-5223(02)73407-7

Figure 1 In stepwise gastroplasty, only the seromuscular layer was incised along a curved line parallel to the greater curvature (A). Then, the lesser curvature was extirpated by dividing the remaining mucosal layer with the suturing device (B). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1306-1312DOI: (10.1016/S0022-5223(02)73407-7)

Figure 2 In standard gastroplasty, after the stomach was stretched as far as possible, the full thickness of the stomach was divided along a curved line parallel to the greater curvature with the suturing device. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1306-1312DOI: (10.1016/S0022-5223(02)73407-7)

Figure 3 A circular stapling device was introduced through the gastrotomy at the top of the gastric tube and passed through the posterior wall of the gastric tube. The anvil and stapler were then approximated, and the instrument was fired. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1306-1312DOI: (10.1016/S0022-5223(02)73407-7)

Figure 4 Changes of TBF at 1-cm intervals from the top of the gastric tube. There was no statistical difference in TBF at the same distances from the top of the gastric tube between the stepwise group and standard group. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 1306-1312DOI: (10.1016/S0022-5223(02)73407-7)