Fig 1

Reconstruction of the Flap Tunnel and Gastroesophageal Anastomosis. A A 4×20 cm gastric tube was prepared extracorporeally. The flap tunnel was 2.5×2 cm in size, with careful dissection between the muscular and submucosal layers. During laparoscopy, a small hole was made 1 cm below the tunnel's lower edge. B The esophageal stump was pulled down through the tunnel, and the gastric tube was inserted into the lower mediastinum. C Three to four stitches were placed between the esophagus and the tunnel to prevent retraction. Continuous suturing of the gastroesophageal anastomosis was then performed. D The muscular flap was pulled down and sutured to the stomach to comprehensively cover the gastroesophageal anastomosis. E. The gastroesophageal anastomosis was completed.