Fig. 1

a The gastric tube was pulled up to the left neck incision, with apposition of posterior walls of the esophagus and gastric tube; a 1-cm gastrostomy was created at the posterior wall of the gastric tube. The anvil was placed in the remnant esophagus, and the staple cartridge was placed in the gastric tube. b After firing and removing the first linear stapler, a nasogastric tube (white arrow) was inserted and advanced downward into the gastric tube. The common opening in the stomach and esophagus were then grasped with Allis clamps and placed together for closure. c The second 60-mm linear staplers were fired transversely in an everted fashion. The common opening (white arrows) was closed and the tip of the gastric tube was excised. d The staple line was reinforced by interrupted serosal sutures with 4-0 absorbable Vicryl antibacterial sutures. The cervical DSA was completed