An nasogastric tube is pushed into the stomach in order to identify both lumens. It is important to clamp the NG tube to avoid losing the pneumoperitoneum. Another view of the surgical field. Stay sutures have been placed to line up the opening before starting the closure. Interrupted simple stiches are being placed.
Care is taken to include the mucosa in each stich.
Stiches are placed from both corners working towards the middle to reduce the tension at the suture line. The nasogastric tube is left in place during the closure . The closure has been completed. This shows the marked widening of the stricture area. The sutureline was tested under water, insuflating air through the nasogastric tube to the stomach.