Reconstruction at this point may be somewhat surgeon biased, but any choice should be reproducible with the hand-assist method. Also note that although we favor the reconstruction laparoscopically, a certain degree of the reconstruction may be done open through the exposure created by the base retractor. We prefer to fashion a Roux-en-Y esophagojejunostomy in a side-side technique using laparoscopic linear staplers. Another option would be an end esophagus to side jejunum using a circular stapler (23 mm). In either case an appropriate distal limb of jejunum is chosen and transected. The Roux limb is brought up to esophagus. For the side-side technique, enterotomies are fashioned in esophagus and Roux limb.