The posterior serosal layer of interrupted mattress sutures of 00 silk anchors the jejunum to the entire remaining end of the stomach. This is done to avoid undue angulation of the jejunum; it removes strain from the site of the stoma and reinforces the closed upper half of the stomach posteriorly (Figure 5). Following this, the crushed or stapled gastric wall still retained in the Babcock forceps is excised with scissors, and any active bleeding points are tied (Figure 6). The contents of the stomach are aspirated by suction unless it has been possible to apply an enterostomy clamp on the gastric side. The mucosa of the stomach and the jejunum toward the greater curvature are approximated by a continuous fine absorbable suture on an atraumatic needle (Figure 7). Some prefer interrupted sutures of 000 silk. A Connell-type stitch is used to invert the angles and the anterior mucosal layer (Figure 8). A layer of interrupted mattress sutures is continued anteriorly from the closed portion to the margin at the greater curvature. Both the angles of the lesser and greater curvatures are reinforced with additional interrupted sutures. The long tails retained from closing the upper portion of the stomach are rethreaded on a spring-eye French needle (if still available to the surgeon). Otherwise, new nonabsorbable sutures are placed (Figure 9). These sutures are utilized to anchor the jejunum to the anterior gastric wall and buttress the closed end of the stomach anteriorly, as was previously done on the posterior surface. The stoma is tested for patency as well as for the degree of tension placed on the mesentery of the jejunum. The transverse colon is adjusted behind the jejunal loops going to and from the anastomosis. If a retrocolic anastomosis has been performed, the margins of the mesocolon are anchored to the stomach about the anastomosis (Plate 28, Figure 10).