title: Bladder rupture - a rare complication of extraperitoneal balloon dissection during robot-assisted radical prostatectomy.
abstract: BACKGROUND
  Balloon dissection to create the extraperitoneal space to facilitate laparoscopic procedures is generally a safe step. However, complications can include vascular and visceral injuries. Bladder injury during balloon dilation of extraperitoneal space has previously been described during herniorraphy. This is the first reported case of bladder injury during balloon dilation of the extraperitoneal space during robot-assisted radical prostatectomy.
  
  
  METHODS
  We report transection of bladder at the prostato-vesical junction, during balloon dilation of extraperitoneal space, in a 66-year-old man undergoing extraperitoneal robot-assisted radical prostatectomy.
  
  
  RESULTS
  The patient had an uneventful procedure due to immediate recognition of this intra-operative complication. At 6-month follow-up, he reports complete return of urinary continence and is free from biochemical recurrence from prostate cancer.
  
  
  CONCLUSIONS
  Albeit uncommon, balloon-related complications can occur. Surgeons performing extraperitoneal laparoscopic procedures should be aware of the range of potential complications specifically related to balloon dilation of extraperitoneal space. With experience, these complications can be mitigated.
authors.affiliation: Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Vineet
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Joseph
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D004210:Dissection / Q000009:adverse effects* / Q000379:methods; D004867:Equipment Design; D006801:Humans; D008297:Male; D010537:Peritoneum / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D065287:Robotic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D012421:Rupture / Q000209:etiology / Q000473:pathology; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries* / Q000473:pathology
keywords: balloon rupture; extraperitoneal; prostate cancer; robot-assisted prostatectomy