The technique to replace the esophagus with the greater curvature consists in making an incision 2cm proximal to the pylorus, followed by application of the GIA stapler four or five times along the greater curvature until the desired length of the tube is obtained. The diameter should not exceed 2cm. No pyloroplasty is needed and the spleen is left in situ in most instances. The tube is elevated into the neck retrosternally and anastomosed to the remaining esophagus or pharynx.