The posterior approach can be utilized laparoscopically to remove the adrenal gland. The patient is positioned on an Andrews frame Access is obtained by blunt dissection above the iliac crest into the posterior aspect of Gerota's fascia. The Origin balloon expander is inserted and inflated until the diaphragm is visualized and the working space established. Two or three additional ports are then added. In our early experience, we have been successful in four of six attempts with decreased postoperative discomfort and the patient being discharged after 48 hours.