The anterior approach to the adrenal gland

The traditional approach to the adrenal gland is via a loin incision. While this is frequently the ideal approach for unilateral disease if both adrenals are to be examined or removed the surgeon must choose between bilateral loin incisions and a transabdominal approach. A bilateral posterior approach may be made with the patient is a prone, semi-jacknife position. This, however, is often unsuitable for sick patients, and of course does not permit the surgeon to perform a laparotomy or simultaneous oophorectomy if this is considered necessary. We feel, therefore, that an anterior approach merits serious consideration.