Posterior retroperitoneoscopic adrenalectomy is a safe, minimally invasive approach to adrenalectomy that allows early access to the adrenal vein. Popularized by Dr. Martin Waltz, this technique is beneficial in patients with previous abdominal surgery because it avoids intra-abdominal adjacent organ mobilization, and is unaffected by the presence of intra-abdominal adhesions.

The technical aspects of multiple posterior retroperitoneoscopic adrenalectomies were recorded. A video was created reviewing and depicting the indications, positioning, anatomic considerations and critical technical maneuvers of the operative procedure.

The video illustrates with clarity the operative techniques for posterior retroperitoneoscopic adrenalectomy for both the left and right adrenal glands.

Posterior retroperitoneoscopic adrenalectomy is a safe technique that provides direct access to the adrenal glands. Proper orientation of the retroperitoneal landmarks and dissection in the correct plane is critical to technical success and efficiency.