Modified thoracoabdominal approach to the kidney and retroperitoneal tissue

Exposure to the retroperitoneal space may be improved by performing thoracotomy through the 8th rib bed rather than the 9th or 10th and by combining a subcostal incision with the standard longitudinal abdominal incision. This modification of the standard thoracoabdominal incision has been used to remove giant hypernephromas, to perform radical nephrectomies with node dissection and to remove retroperitoneal lymphatic structures in non-seminomatous testis tumors.