Key Points

• Gastroplasty is an esophageal lengthening technique that reduces tension on an antireflux repair in patients with “short esophagus.”
• Diagnosis of short esophagus is made from information gained through barium esophagography, esophagoscopy, manometry, and intraoperative findings.
• Removal of the gastroesophageal “fat pad” follows the technique used during highly selective vagotomy.
• A gastric tube of 4 to 5 cm of uniform diameter (48 Fr) is created with a linear cutting stapler.