Adrenalectomy is ideally suited to minimally invasive surgery. The adrenal glands can be approached endoscopically using either transperitoneal or retroperitoneal access. The transabdominal lateral approach is more direct, allows the gravity-facilitated exposure of the adrenals and results in less dissection than does the anterior approach. The transabdominal lateral approach is currently the most widely practiced approach since it provides a wide operative field and direct access to the blood vessels.