Atraumatic Gastric Transposition After Transhiatal Esophagectomy

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Presentation transcript:

Atraumatic Gastric Transposition After Transhiatal Esophagectomy Robert J Korst, Mithran Sukumar, Michael E Burt The Annals of Thoracic Surgery Volume 64, Issue 3, Pages 867-869 (September 1997) DOI: 10.1016/S0003-4975(97)00637-1

Fig. 1 After transhiatal esophagectomy, a urinary catheter has been placed in the posterior mediastinum (see text). The stapled and divided cervical esophagus is seen in the neck. An unraveled laparoscopy camera sheath has been fastened to the distal end with a heavy silk tie and the balloon inflated. The gastric tube has been prepared and is ready for transposition to the neck. The Annals of Thoracic Surgery 1997 64, 867-869DOI: (10.1016/S0003-4975(97)00637-1)

Fig. 2 The gastric tube is inserted into the plastic sheath with 25 mL of saline solution and the sheath is unraveled to cover the entire stomach. The Annals of Thoracic Surgery 1997 64, 867-869DOI: (10.1016/S0003-4975(97)00637-1)

Fig. 3 Suction is applied to the catheter and the surgeon’s hand provides a seal. Once the vacuum is created, the surgeon’s hand is loosened and is used to gently guide the gastric tube through the mediastinum. The Annals of Thoracic Surgery 1997 64, 867-869DOI: (10.1016/S0003-4975(97)00637-1)

Fig. 4 The urinary catheter is withdrawn from the cervical incision until the balloon is delivered into the neck along with the gastric fundus. The plastic sheath is incised to release the vacuum and is easily removed from the mediastinum leaving the gastric tube in excellent position. The Annals of Thoracic Surgery 1997 64, 867-869DOI: (10.1016/S0003-4975(97)00637-1)