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Objective To study the feasibility and safety of da Vinci robot-assisted laparoscopic resection of complicated pheochromocytomas with large vessels involvement.Methods Three large pheochromocytomas of 3 patients were resected through da Vinci robot-assisted laparoscopic surgery from February 2015 to March 2015.One patient was male and 2 patients were female.Two patients presented with paroxysmal dizziness,palpitation and hypertension,and another with palpitation and chest pain.CT,ultrasound and laboratory results all indicate the diagnosis of pheochromocytoma.Two cases presented with right-sided adrenal pheochromocytoma located between the liver and vena cava,one presented with left-sided para-aortic paraganglioma located in the level of middle to lower part of left kidney.The tumor size was 5.9 cm×5.7 cm,7.3 cm×4.9 cm,and 5.8 cm×4.8 cm,respectively.All surgeries were performed by lateral transperitoneal approach.Four trocars (3 robotic arms and 1 assistant port) were used in the operation of left-sided tumor and 5 trocars (3 robotic arms and 2 assistant ports) were used in the operations of right-sided tumors.Results All three operations were successful,fluctuation of blood pressure (>50 mmHg) was observed in 1 case.The mean docking time of da Vinci surgical system was 10 minutes.The operative time was 120,60,and 85 min,respectively.The estimated blood loss was 200,100,and 200 ml,respectively.The length of stay was 5,7,and 4 days,respectively.Symptoms disappeared and blood pressure returned to normal level after the surgeries.Postoperative hemorrhage or infection as well as other complications were not found.The diagnosis of pheochromocytomas was confirmed by pathology.No recurrence was found during the follow-up of 2 to 3 months.Conclusion For complicated pheochromocytomas compressing large vessels like vena cava and aorta,resection through conventional laparoscopy surgery may be difficult.Da Vinci robot-assisted laparoscopic surgery may have the advantage of more delicate and safe manipulation and less complications,which deserves widespread use.