Anterior Adrenalectomy:
  • Laparotomy and survey abdomen.
  • Left side= take down splenic flexure
  • Right side= take down hepatic flexure, kocherize the duodenum, take down right triangular ligament.
  • Enter gerota's fascia, start cephalad, and dissect towards renal hilum.
  • Dissect between adrenal and pancreas/spleen (left) or liver (right).
  • Identify adrenal vein and ligate (left side renal vein, right side off posterior surface of IVC).
  • Continue dissection over renal capsule.
  • Remove retroperitoneal fat with the adrenal gland.