Miss W, a 26-year-old graduate of a prestigious Chinese university with a master’s degree, is a talented woman of show. The discovery of hypertension sent her to the hospital for examination. A comprehensive endocrine examination was performed and a familial type bilateral adrenal pheochromocytoma with VHL mutation was diagnosed, in which the right tumor was huge, 8 – 9 cm, penetrating deep behind the vena cava. After discussion, it was decided to perform resection of the right adrenal giant tumor first. Following the general surgical approach: a 40–45 cm surgical incision, the ligament of the liver was removed and the liver was turned to the left. This will expose the vena cava, which will then be freed and the tumor behind the vena cava will be removed. The operation takes 2-3 hours and bleeds 1000-2000ml or even 3000-4000ml, which cannot be done by normal laparoscopic surgery. Professor Shen Zhoujun, who has been in charge of 450 cases of robot-assisted laparoscopic surgery and completed 150 cases of adrenal robot-assisted laparoscopic surgery, has more experience in compressing huge adrenal tumors in the vena cava and has reported related surgeries in international conferences. However, the surgery of giant pheochromocytoma behind the vena cava, operated by robot-assisted laparoscopic device, has not been reported at home and abroad. After thorough preparation, on January 26, 2015 (Monday), Prof. Shen Zhoujun’s team, with the cooperation of colleagues from the Department of Anesthesiology and the operating room, successfully removed the tumor completely. The intraoperative bleeding was 200ml and the operation time was 1 hour and 07 minutes. A few holes and 4ml small incisions replaced the 40 – 45ml incision. The patient was able to get out of bed 3 days after surgery. He was discharged successfully one week later (February 2nd).