Remove the retroperitoneal (pararenal) fat on both sides of the vertebral column between the level of the T12 to L3 vertebra to expose the anterior layer of the renal fascia . Make a vertical incision through the renal fascia and remove the perirenal fat which surrounds the kidneys and suprarenal glands (Figure 40.1).
Identify the right suprarenal gland and left suprarenal gland. These are important endocrine organs located in close relationship to the superior pole of the respective kidney. The inferior surface of the suprarenal gland contacts the upper pole of the kidney. Posteriorly, each suprarenal gland rests against the lumbar part of the diaphragm (Figure 40.2).
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