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Risks & Possible Complications

Robotic / VATS Lung Resection
What the published evidence says about risk

Every operation carries risk. This page summarizes the risks of robotic and VATS lung resection (lobectomy or segmentectomy) in plain language, using figures reported in large published studies. This is general information, not your individual risk assessment — Dr. Irshad will review your own risk factors, imaging, and lung function with you directly as part of your consent discussion before surgery.

Risks & possible complications

  • Death within 30 days — about 1.5%. The most common cause is a serious lung or heart complication rather than the surgery itself.
  • Major complications overall — about 10%. This includes any complication serious enough to need extra treatment, a longer hospital stay, or a return to the operating room.
  • Prolonged air leak — roughly 12–18%. Air continues to leak from the lung through the chest tube for several days; usually managed by leaving the tube in longer, occasionally needs a small additional procedure.
  • Irregular heart rhythm (atrial fibrillation) — roughly 10–15%. Usually temporary and treated with medication.
  • Pneumonia — roughly 4–6%.
  • Bleeding requiring a return to the operating room — under 1%.
  • Need to convert to an open incision — roughly 3–13% (lower, around 3%, with the robotic approach). This is a safety decision, not a failure of the operation.
  • Rare but reported: injury to a nearby nerve, leakage of lymph fluid into the chest (chylothorax), or an abnormal connection between the airway and chest cavity (bronchopleural fistula) — each well under 3%.
Your own risk varies. Rates are higher with reduced lung function, prior chest surgery or radiation, active smoking, and larger or more central tumours requiring more extensive resection. Ask Dr. Irshad how these factors apply to you.

References

  1. Kozower BD, et al. The Society of Thoracic Surgeons Composite Score for Rating Program Performance for Lobectomy for Lung Cancer. Ann Thorac Surg. 2016;101(4):1379–86. PubMed
  2. Kneuertz PJ, et al. National Trends and Outcomes of Segmentectomy in the STS Database. Ann Thorac Surg. 2022;113(4):1361–9. PubMed
  3. Zhang J, et al. Updated Evaluation of Robotic- and Video-Assisted Thoracoscopic Lobectomy or Segmentectomy. Front Oncol. 2022;12:853530.
  4. Casiraghi M, et al. 1000 Robotic-assisted lobectomies for primary lung cancer: 16 years single center experience. Lung Cancer. 2024;195:107903.

Common questions about risk

What is the risk of death from lung resection (lobectomy) surgery?
About 1.5% of patients die within 30 days of VATS or robotic lung resection, based on Society of Thoracic Surgeons national database figures. The robotic approach and experienced high-volume centres tend to have lower rates.
What are the most common complications of VATS or robotic lung resection?
The most common complications are a prolonged air leak (roughly 12–18%) and irregular heart rhythm or atrial fibrillation (roughly 10–15%). Overall, about 10% of patients experience a major complication.
How often does lung resection surgery need to be converted from minimally invasive to open?
Conversion to an open incision happens in roughly 3–13% of cases, and is lower — around 3% — with the robotic approach. It is a safety decision made during surgery, not a failure of the operation.
What rare but serious complications can occur after lung resection?
Rare complications include injury to a nearby nerve, leakage of lymph fluid into the chest (chylothorax), and an abnormal connection between the airway and chest cavity (bronchopleural fistula) — each occurring in well under 3% of patients.
This page is general information, not medical advice or a consent form. It does not replace the individualized consent discussion you will have with Dr. Irshad, which accounts for your own health, anatomy, and the specific operation planned. If you are experiencing a medical emergency, call 911 or go to your nearest Emergency Department immediately. Published in compliance with the CPSO Advertising Standards Policy.

Questions about your risk?

Dr. Kashif Irshad — Division of Thoracic Surgery, William Osler Health System, Brampton Civic Hospital. Tel: (905) 458-4520 · Fax: (905) 458-4080 · thoracic@williamoslerhs.ca

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