Yuchen Bai, Xuanhan Hu, Dechao Feng, Dahong Zhang, Qijun Wo
Hemodynamic instability during pheochromocytoma resection remains a critical challenge. This study evaluates an intelligent pneumoperitoneum system (Zhonghe Third-Generation) that dynamically modulates intra-abdominal pressure (IAP) to mitigate catecholamine surge. The study was retrospective analysis of 93 patients who under robotic adrenalectomies since 2020 to 2025 years. Which including 43 with synergy group and 50 conventional controls. Thestudy was reveals that synergy group reduced AUC by 43.1% (18.3 ± 5.2 vs 24.7 ± 9.2 mmHg, P < 0.001).Lower peak SBP (178.9 ± 20.7 vs. 195.4 ± 23.8 mmHg, p < 0.001) and vasopressor requirements (1.2 ± 0.8 vs. 3.1 ± 1.5 doses, p < 0.001).Shorter operative time (58.4 ± 16.2 vs. 66.8 ± 12.4 min, p = 0.018). Intelligent pneumoperitoneum significantly enhances hemodynamic stability without compromising safety, advancing precision in robotic endocrine surgery.