2021 AMI Online Salon

Shoeshine Maneuver during Paraesophageal Hernia Repair

Project Details

  • Entrant Name:  Susie Yun
  • Client: David Rini
  • Copyright: Susie Yun, 2020
  • Medium/software used: Adobe Photoshop
  • Final presentation format: PowerPoint Slide
  • Primary Audience: Surgeons and Residents

Project Description

This surgical illustration depicts the retro-esophageal passage of fundus during robot-assisted paraesophageal hernia repair. The back-and-forth motion of the “shoeshine” maneuver is shown in white arrows. This maneuver is a critical step prior to fundoplication, as it ensures adequate mobility and prevents tension of the fundus wrapped around the esophagus. During the procedure, the vagus nerves are not easily visible and special care must be taken to preserve them. In this illustration, the vagus nerves are emphasized by using a conventional yellow color, which depicts their course along the lesser curvature of the stomach. In addition, the Bougie dilator, which is used to maintain the diameter of the esophagus during the procedure, is depicted using transparency to visualize its position inside the esophagus and the stomach.