The adrenals lie above the upper poles of the kidneys (see renal anatomy) abutting the roots of the diaphragmatic crura and the aorta and vena cava on their respective sides. They are enclosed in perinephric fat within the upper recesses of Gerota's fascia, and a layer of fat separates them from the kidneys.
This patient underwent open hysterectomy in conjunction with her adrenal surgery. After completion of the hysterectomy, the patient was rotated left side up, and the left parietal peritoneum was separated to mobilize the spleen and pancreas medially (partial medial visceral rotation).
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