A vagotomized, tubularized gastric conduit is the most commonly used conduit for reconstruction of the thoracic esophagus at esophagectomy. However, the gastric conduit is an imperfect esophageal replacement. The conduit has no receptive relaxation and has a reduced capacity compared with the native stomach. There is decreased antral motility, and gravity is the major determinant of conduit drainage. A pyloric drainage procedure, such as a pyloroplasty or pyloromyotomy, facilitates the emptying of the gastric conduit and may improve foregut function and quality of life after esophageal resection.1 Critics of this approach are concerned that a pyloroplasty may lead to excessive bile reflux and too rapid emptying of the stomach. At our institution, we have developed a minimally invasive Ivor Lewis esophagectomy to treat resectable cancer of the esophagus and gastroesophageal junction.2,3 To optimize conduit function and emptying, we construct a narrow, straight gastric conduit, 3-4 cm in diameter, and perform a pyloroplasty. Here, we describe a technique of minimally invasive, Heineke–Mikulicz pyloroplasty, which we routinely perform within the context of a minimally invasive, Ivor Lewis esophagectomy.