A stapling instrument, which creates end-to-end inverting anastomoses, is described for esophagogastrostomy. The inverted anastomosis is held together by a double staggered row of stainless-steel wire staples. Experience with 7 consecutive patients who underwent esophagogastrectomy for carcinoma of the distal esophagus or proximal stomach using this device is reported. Postoperative complications included atelectasis in 1 patient, cardiac failure in 1, and pneumonia in 1. A fibrotic stricture developed at the anastomotic site 5 months postoperatively in 1 patient. There were no anastomotic leaks. The stapled anastomosis takes 2 to 3 minutes to perform and seems to be at least comparable to handsewn anastomoses.