Adrenalectomy

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.