Upon completion of devascularization, the esophagus is doubly clamped with pairs of specially ordered esophageal clamps of the noncrushing, nonslipping type similar to Botallo's forceps ("Sugiura's clamp"). The distance between the two clamps is approximately 4 cm. The two clamps are jointed with a thumbscrew in the mid-portion.
Esophageal transection is performed at the level of the diaphragm. The anterior muscular layer is divided with a knife and a tape passed around the submucosal layer.
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