Right Triangular Ligament of the Liver

• Take down the right triangular ligament of the liver to expose the right adrenal gland.
• Gland is right next to the vena cava (IVC = inferior vena cava)

Open right adrenalectomy

• Mobilize the right lobe of the liver and the hepatic flexure of the colon
• Enter the retroperitoneum
• Reflect the duodenum and head of pancreas medially (Kocher maneuver)
• The Kocher maneuver exposes the right adrenal gland and inferior vena cava.