**3.4 Postoperative care**

Intravenous fluid should be kept on the first day until the upper GI study confirms free-flowing contrast through the anastomosis, with no interruption or delay of the flow. This is critical, especially after concomitant hiatal hernia repair. Ambulation and incentive spirometry use are necessary to be reminded by the managing team. Anticoagulant medications should be resumed based on the guidelines followed. Before discharge, instructions about diet progression, activity, and specific ominous symptoms requiring attention are explained to the patient.

**Figure 13.** *Twisted sleeve. The dashed line illustrates the unequal stapling.*
