# Bilateral simultaneous laparoscopic clipless adrenal-sparing surgery for pheochromocytoma in a pediatric patient: A case report

## TL;DR

A child with Von Hippel-Lindau disease successfully had both adrenal glands partially removed using laparoscopic surgery, avoiding hormone replacement and maintaining normal blood pressure.

## Contribution

A novel laparoscopic clipless adrenal-sparing surgical approach for pediatric bilateral pheochromocytoma is presented.

## Key findings

- The patient remained normotensive and asymptomatic six months post-surgery.
- Adrenal insufficiency did not occur, avoiding the need for hormone replacement therapy.
- Bilateral simultaneous adrenal-sparing surgery is feasible and effective in pediatric cases.

## Abstract

Herein, we describe an 11-year-old male with a known history of Von Hippel-Lindau disease. He presented with malignant hypertension and bilateral adrenal masses measuring approximately 5cm and 3cm on the right and left sides, respectively. Pheochromocytoma was confirmed through imaging and lab data. The patient successfully underwent bilateral simultaneous laparoscopic clipless adrenal-sparing surgery. At the six-month follow-up, he remained asymptomatic and normotensive, normal laboratory tests or imaging. Additionally, there were no signs of adrenal insufficiency, eliminating the need for corticosteroid or mineralocorticoid replacement therapy. Laparoscopic bilateral synchronous adrenal-sparing surgery represents a significant advancement in the management of pediatric bilateral pheochromocytoma.