Posterior transthoracic approach for adrenal surgery.

We present a modification of the posterior surgical approach for adrenalectomy wherein the pleura and diaphragm are directly incised to expose the adrenal gland. This technique has been used in 20 patients undergoing adrenalectomy for hyperplasia or a small benign adenoma. In our series chest tube drainage usually was not necessary, operative morbidity was minimal and most patients were discharged from the hospital within 1 week postoperatively. The posterior surgical approach remains an excellent method to perform adrenalectomy in selected patients. The transthoracic modification described can enhance operative exposure of a high-lying adrenal gland through this incision, particularly on the right side.