Several studies attest to the clinical superiority of the Retroperitoneal approach over the transabdominal route for the repair of abdominal aortic aneurysms, and recent evidence demonstrates reduced physiological disturbance with this technique. We have found the Risberg incision gives excellent exposure without loss of the advantages of the retroperitoneal approach. We have now used this incision in 25 patients undergoing elective repair of abdominal aortic aneurysms. This videotape demonstrates the positioning of the patient, the Risberg incision, the retroperitoneal exposure and dissection of the aorta, and the insertion of a woven synthetic graft.