Atraumatic gastric transposition after transhiatal esophagectomy

Transhiatal esophagectomy using the stomach for esophageal replacement requires that the gastric 'neoesophagus' be transferred from the peritoneal cavity through the posterior mediastinum into the neck under blind conditions. This process is associated with stretching, tearing, and hematoma formation in the most critical portion of the gastric tube, that to be used for the anastomosis. A technique is described for this procedure that is simple to perform and, most importantly, completely atraumatic to the gastric conduit.