What maneuver is used to examine the posterior wall of the stomach?

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Last updated: March 11, 2026 • View editorial policy

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J-Manoeuvre for Posterior Gastric Wall Examination

The J-manoeuvre (retroflexion) is the standard technique used to examine the posterior wall of the stomach during upper gastrointestinal endoscopy 1.

Technique and Application

During a complete upper GI endoscopy, the fundus and posterior gastric wall must be inspected using the J-manoeuvre in all patients 1. This involves:

  • Retroflexing the endoscope to create a "J" shape within the stomach
  • Allowing visualization of the fundus and posterior gastric wall that cannot be adequately seen in the forward-viewing position
  • Examining the gastric cardia and fundus systematically

Quality Standards

The British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons explicitly mandate that the fundus should be inspected by J-manoeuvre in all patients as part of a complete OGD examination 1. This is not optional but rather a required component of a high-quality diagnostic examination.

Additional Considerations in Hiatus Hernia

When a hiatus hernia is present, the diaphragmatic pinch should be specifically inspected while maintaining the retroflexed position 1. This ensures complete evaluation of the gastroesophageal junction anatomy.

Documentation Requirements

Photo-documentation should capture the retroflexed view as part of the systematic approach to recording anatomical landmarks during upper endoscopy 1. This serves multiple purposes:

  • Encourages thorough mucosal inspection
  • Provides legal documentation of complete examination
  • Allows detailed review without patient movement artifact

The J-manoeuvre is essential for detecting lesions on the posterior gastric wall and fundus that would otherwise be missed during standard forward-viewing endoscopy.

References

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