Introduction: The intraoperative use of Indocyanine Green (ICG) for gastric conduit perfusion during esophagectomy might reduce the incidence of anastomotic leakage. We present a video illustration of the technique.

Methods: We present a case of a 54-year-old male patient diagnosed with hiatal hernia, GERD and Barrett's esophagus. After an episode of melena, he underwent esophagogastroduodenoscopy (EGD) and an esophageal adenocarcinoma was confirmed after biopsy. After PET-scan ruling out metastasis, chemotherapy was started and patient was referred to surgery.

Results: After laparoscopic accessing the abdominal cavity and no evidence of intra-abdominal disease, a gastric conduit was done using the linear stapler and then brought up to the chest. Then, a jejunostomy tube was placed 50 cm distal to the ligament of Treitz and fixed to the anterior abdominal wall. After that, dissection of the esophagus was performed through thoracoscopy. The specimen was transected and then histopathological analysis showed free margins. ICG fluorescence was used to check distal esophageal and gastric conduit perfusion, which were proper. Hence, a transoral esophagogastrostomy was performed without complications. A Blake drain and chest tube were then inserted, and patient went to the recovery room. On 6^th postoperative day (POD) tube feeding started and upper GI study showed no leakage. The patient was discharged on 16^th POD.

Conclusion: Anastomosis leakage is one of the most dreadful complications in GI reconstructive surgeries and the use of ICG intraoperatively has been shown to be helpful to avoid such problem.