Functional anatomic reconstruction of the cardia.

Experiments on bastard dogs have shown that cardia reconstruction using an omega sling is effective. This sling is a pedicled, extramucosally excised, longitudinal muscle flap from the ventral aspect of the greater gastric curvature, which is prestretched at least 100%, wrapped around the cardia twice and sutured to the posterior gastric wall. A physiological pressure gradient is created with the help of intraoperative manometry. Perfusion manometry, radiology, histology and microangiographs demonstrate the competence of the omega sling.