The quality of life for patients with inoperative esophageal cancer is poor due to dysphagia caused by stenosis or development of a tracheoesophageal fistula. One option for these patients is bypass surgery. These patients are often medical compromised and have a poor prognosis. Consequently, any palliative surgical intervention should be definitiuve and minimally invasive. We have improved upon esophageal bypass surgery as originally described by Postlethwait by using a radial stapler to form the gastric tube.