Transgastric approach to posterior juxta-esophageal gastric ulcer

Three cases are reported to illustrate the transgastric techniques for approach to posterior wall juxta-esophageal gastric ulcers. The author emphasizes the importance of making the incision or suture line parallel to the esophagus to avoid compromise of esophageal entry. The advantages of this technique include speed, good direct exposure for a mucosal view, and minimal interruption of gastric blood supply in the exploratory phase before planning a definitive procedure. It is particularly suitable for occasions when surgical risks are increased by obesity or critical clinical status, or when the pathology is strictly localized.