The first laparoscopic resection of extra-adrenal pheochromocytoma using the da Vinci robotic system.

Laparoscopic surgery for pheochromocytoma is difficult because of the potential release of catecholamines, which may lead to severe intraoperative hemodynamic changes. In particular, extra-adrenal pheochromocytoma imposes special demands on the laparoscopic surgical skills of the operator because of changes in anatomic disposition. In this paper, we report a case of extra-adrenal pheochromocytoma, located in the vulnerable anatomic structures, taking place in tiny areas that were difficult to access and that was resected by using the da Vinci robotic system. We found that the da Vinci robotic system gave us improved visual quality to surrounding structures. After our initial experience, we suggest the robot-assisted laparoscopic resection for extra-adrenal pheochromocytoma.