Analysis of outcomes of a transoral circular stapled anastomosis following major upper gastrointestinal cancer resection

Daniel M. Foley, Emudiaga J.E. Emanuwa, William R.C. Knight, Cara R. Baker, Mark Kelly, Ricardo McEwan, Janine Zylstra, Andrew R. Davies, James A. Gossage

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5 Citations (Scopus)


BACKGROUND: Esophageal anastomoses performed following esophagectomy and total gastrectomy are technically challenging with a significant risk of anastomotic leak. A safe, reliable, and easy anastomotic technique is required to improve patient outcomes and reduce morbidity. METHOD: This paper analyses 328 consecutive patients who underwent transoral circular stapled esophageal anastomosis (ORVIL™) from a prospectively collected single-center database between December 2011 and February 2019. RESULTS: Two hundred and twenty-seven esophagectomies and 101 gastrectomies were performed using OrVil™ anastomoses. The mean patient age was 63.7 years. Of 328 consecutive OrVil™-based anastomoses, there were 10 clinically significant anastomotic leaks requiring radiological or operative intervention (3.05%). Twenty-eight (8.54%) patients developed anastomotic stricture, all of which were successfully treated with endoscopic balloon dilatation (a median of 1 dilatation was required per patient). CONCLUSION: The OrVil™ anastomotic technique is reliable and safe to perform. This is the largest reported series of the OrVil™ anastomotic technique to date. Leak rates and anastomotic dilations were similar to other reported series. Based on our experience, we consider the use of the OrVil™ device for reconstruction after major upper GI resection to be safe and reliable.

Original languageEnglish
JournalDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
Issue number11
Publication statusPublished - 11 Nov 2021


  • esophagectomy
  • gastrectomy
  • OrVil™
  • upper GI


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