2022 AMI Online Salon

Nissen Fundoplication

Project Details

  • Entrant Name:  Jiyu Kelly Lim
  • Client: Jennifer Fairman
  • Copyright:  Jiyu Kelly Lim, 2021
  • Medium/software used: Adobe Photoshop / Illustrator
  • Final presentation format: Slide Presentation
  • Primary Audience: General Surgeons

Project Description

Nissen fundoplication is an effective surgical treatment for infants and children with gastroesophageal reflux. One of the most crucial steps in this procedure is the dissection of structures on the right side of the stomach to expose the right crus of the esophagus. Depicted is the 4th of a 15-step surgical illustration series, portraying this moment for an infant undergoing this procedure, as well as the patient’s intra-abdominal anatomy. The right crus is already exposed by the division of the short gastric vessels along the greater curvature of the stomach. While the anatomy on the left side of the stomach is relatively simple, the right side has many layered structures overlying each other that the surgeon needs to carefully dissect through. Subtle didactic color is assigned to important structures to make each distinguishable. The left gastric artery and vagus nerve are also emphasized; it is imperative that structures are divided above the left gastric artery while preserving the vagus nerve.