Numbness After Right VATS Segmentectomy
The numbness on the right side of your abdomen is most likely caused by intercostal nerve injury during the surgical procedure, which is a well-recognized complication of VATS that occurs in approximately 40-47% of patients and may have both neuropathic and non-neuropathic components. 1
Why This Happens
The numbness you're experiencing results from damage to the intercostal nerves during surgery through several mechanisms:
Direct nerve trauma occurs when surgical instruments, port placement, or rib retraction compress or injure the intercostal nerves that run along the ribs and provide sensation to the chest wall and upper abdomen 1, 2
The distribution of numbness extending to your abdomen is anatomically expected because the lower intercostal nerves (T7-T12) provide sensory innervation not only to the lower chest wall but also to the upper abdominal wall 1
Port site trauma is a significant contributor, as even minimally invasive VATS procedures require incisions that can damage intercostal muscles and nerves, particularly when traditional techniques are used rather than blunt separation methods 2
What the Evidence Shows
Research specifically examining chronic pain and sensory changes after thoracic surgery reveals important findings:
Only 53% of chronic pain after VATS has a neuropathic component, meaning nearly half involves other mechanisms such as visceral pain or musculoskeletal injury 1
The prevalence of chronic sensory changes is 40-47% after VATS procedures, which is surprisingly similar to or even higher than open thoracotomy 1
Younger age, more extensive surgery, and pleurectomy are predictive factors for developing chronic pain and sensory disturbances 1
Expected Course and Management
The numbness typically improves gradually over 3-12 months as nerve regeneration occurs, though some degree of permanent sensory change may persist in 20-30% of patients. 1
What You Should Do:
Document the exact distribution of numbness and whether it's accompanied by pain, burning, tingling, or electric shock sensations, as this helps distinguish neuropathic from non-neuropathic causes 1
Report any associated pain immediately to your surgical team, as neuropathic pain requires specific multimodal management including regional anesthesia techniques, NSAIDs, and paracetamol rather than opioids alone 3, 4
Avoid assuming this is "normal" if pain develops, as the PROSPECT guidelines emphasize that VATS can cause severe postoperative pain requiring aggressive multimodal analgesia with regional techniques 3, 4
When to Seek Urgent Evaluation:
New or worsening pain that interferes with breathing or movement requires immediate assessment for potential complications 4, 5
Signs of infection at the incision sites (redness, warmth, drainage) 2
Respiratory symptoms such as shortness of breath or chest tightness that could indicate other postoperative complications 3, 6
Important Caveats
The numbness itself is generally not dangerous, but it can mask other problems - you may not feel pain from abdominal issues in the numb area, so remain vigilant for other symptoms like fever, nausea, or changes in bowel function that could indicate complications unrelated to the nerve injury 1
Newer surgical techniques using 2-cm modified single-port incisions with blunt separation have been shown to significantly reduce postoperative numbness and pain compared to traditional approaches, but this doesn't help your current situation 2