RESUMO
As the use of laparoscopy in urologic surgery gradually increase, the possibility of complication is also increasing. Pneumothorax from many complications is more likely to occur in the urologic surgery than other surgery. A 64-year-old male patient was admitted for laparoscopic multiple renal cysts marsupialization under general anesthesia. About 80 minutes after beginning the operation, the peak airway pressure was suddenly increased and the oxygen saturation was decreased. We suspected the pneumothorax based on decreasing breath sounds in the right chest area and checked for the diaphragmatic injury through communicating with surgeon. Positive end expiratory pressure and hyperventilation was applied to the patient. Surgeon sutured the diaphragmatic injure site, and the chest tube was placed. In conclusion, iatrogenic pneumothorax occurrence during the laparoscopic surgery can be early detected and treated through appropriate monitoring, risk awareness, and close communication with surgeon.