Objective To evaluate the efficacy of retroperitoneoscopic adrenalectomy for pheochromocytoma.Methods From January 2000 to October 2006,a total of 16 patients(aged from 32 to 65 with a mean of 42 years) with pheochromocytoma received retroperitoneoscopic adrenalectomy in our hospital.Among the cases,6 had the tumor on the right side,and 10 on the left.The size of the tumors ranged from 2.5 to 4.6 cm in diameter(mean,3.1 cm).Results The mean preoperative preparation time in this series was 11 days(range,6 to 28).The retroperitoneoscopic adrenalectomy was completed in all but one of the patients,who were converted to open surgery because of extensive adhesion of the tumor to surrounding tissues and massive bleeding.The mean operation time was 110 minutes(90 to 170),and the mean blood loss was 135 ml(80 to 650).Three cases,who had normal blood pressure and thus received no noradrenalin immediately after the surgery,was given noradrenalin emergently 4,6,or 56 hours later owing to a sudden drop of systolic pressure(from 135 mm Hg to 80 mm Hg in 2,and from 140 mm Hg to 85 mm Hg in 1).Postoperative examination showed benign pheochromocytoma in 15 of the cases,and low-grade malignant pheochromocytoma with local invasion of the capsule in the patient who was converted to open surgery.The mean postoperative hospital stay was 12 days(9 to 20).The patients were followed up for 3 to 24 months(mean,13),during which only one received antihypertensive drugs;the others restored normal blood pressure spontaneously.No patient had abnormal levels of 24-hour urine noradrenalin,adrenalin,and catecholamine.Conclusions Retroperitoneoscopic surgery is an effective and minimally invasive treatment for patients with adrenal pheochromocytoma.The patients have a few complications and recover quickly after the operation.Preoperative preparation and postoperative treatment are important for the outcomes of the disease.