A combined laparoscopic-endoscopic method of assessment to prevent the complications of short esophagus

As antireflux surgery has been used increasingly for gastroesophageal reflu x disease (GERD), a need has arisen for an accurate method to assess esopha geal length. There are a number of preoperative tests that can help surgeon s to establish the presence of a short esophagus, but intraoperative assess ment after esophageal mobilization is the standard method. In this era of l aparoscopic surgery, the surgeon mobilizes the esophagus extensively from t he abdomen and then determines if mobilization is sufficient. We report an intraoperative technique that combines laparoscopic with endoscopic methods to determine the position of the gastroesophageal junction, Because two ph ysicians are required, then is additional operating room time, resulting in increased costs. However, these costs are offset by the assurance that the complications of the short esophagus can be avoided. With experience, modi fications were made, resulting in the technique described herein.