Esophageal carcinoma is a difficult neoplasm to treat, with a reported overall 5-year survival of about 15%. The role of chemotherapy and radiation has yet to be defined, making surgical resection the standard treatment. Postoperative esophageal leak remains a significant contributor to morbidity and mortality, especially after an intrathoracic anastomosis. We propose a modification of the Ivor Lewis esophagogastrectomy that has resulted in two anastomotic leaks in a series of more than 500 patients.