Novel detachable purse-string suture instrument-assisted end-to-end esophagojejunostomy using a circular stapler

This study evaluated a novel detachable purse-string suture instrument-assisted esophagojejunostomy technique using a circular stapler for minimally invasive surgery. The detachable purse-string suture instrument facilitated simplified anvil placement, enhanced visualization, and allowed flexible manipulation without the addition or extension of an incision. A total of 22 patients with gastric or esophagogastric junction cancer underwent this procedure at our institution between January 2023 and December 2024. The median intracorporeal anastomosis time for esophagojejunostomy (excluding the time required for extracorporeal jejunal limb creation and jejunojejunostomy) was 54.5 min, with no cases of anastomotic leakage. Conversion to hand-sewn methods was required in two cases due to technical difficulties. Two patients required endoscopic dilation for stenosis within one year. This method demonstrated favorable short-term outcomes and may be a safe and effective alternative to esophagojejunostomy in minimally invasive surgeries. Large-scale studies are warranted to validate the long-term efficacy and broad applicability of this method.