The esophagus is encircled with a Penrose drain, and the crus of the diaphragm is taken down bilaterally. Following skeletonization of the distal esophagus, four stay sutures of 2-0 Prolene are placed circumferentially in the esophagus approximately 2 cm proximal to the presumed gastroesophageal junction. An automatic pursestringer and circular stapling device and knife are used to transect the distal esophagus.
