[Tricks, errors and dangers in use of staplers in the upper gastrointestinal tract]

Special technical procedures are the prerequisite for the successful use of stapling techniques in surgery of the upper GI tract. Organ surfaces which are to be connected by staplers have to be cleaned meticulously of all fat and mesenterium. Purse string sutures in the hiatus oesophagei should be done by hand. The instrument has to be inserted carefully to avoid leasons of the mesenterium. Kinking of bowel segments has to be avoided; the bowel or gastric segments must be spread over the circular staplers. Anastomoses should be checked for bleeding and patency. Thus stapling can be done successfully in routine resections of the stomach and in the transabdominal approach to cardia region and lower esophagus.