We describe two patients who underwent resection of phaeochromocytoma by a laparoscopic approach. Although outcome from surgery was successful, there was marked variability in hormonal and haemodynamic changes. In one patient, despite an infusion of nicardipine, peritoneal insufflation produced a marked increase in catecholamine concentrations associated with transient but intense vasoconstriction, but there was no change in the second patient. In both patients, exsufflation caused no significant haemodynamic changes in spite of the high doses of nicardipine given throughout the procedures.