Abstract
BACKGROUND: Pneumomediastinum represents a rare but potentially serious complication of robotic-assisted radical nephrectomy, often resulting from carbon dioxide insufflation during retroperitoneal surgery. CASE PRESENTATION: Reported here is a case of a 78-year-old female who underwent an uneventful robotic-assisted radical nephrectomy for a right renal mass but presented 5 days postoperatively with shortness of breath and chest discomfort. Imaging confirmed extensive pneumomediastinum without esophageal perforation. She was managed conservatively with oxygen therapy, pain control, and a soft diet, leading to full recovery. CONCLUSION: Awareness of risk factors, such as a low body mass index, prolonged operative time, and extensive retroperitoneal dissection, is essential for early recognition and management of this rare complication.