Table 3

Surgical Options

Disease Approach
Primary hyperaldosteronism Posterior (left or right)
Modified posterior (right)
11th Rid (left>right)
Posterior Transthoracic
Cushing's adenoma 11th Rib (left or right)
Thoracoabdominal (large)
Posterior (small)
Cushing's disease Bilateral posterior
Bilateral 11th Rib (alternating)
Adrenal carcinoma Thoracoabdominal
11th Rib
Transabdominal
Bilateral adrenal ablation Bilateral posterior
Pheochromocytoma Transabdominal Chevron
Thoracoabdominal
  (large-usually right)
11th Rib
Neuroblastoma Transabdominal
11th Rib

(From: Vaughan ED Jr: Adrenal surgery, in Operative Urology, F Marshall (ed). W.B.Saunders, 1991.)

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