This is a video presentation of a case of a 59 year old female with a right-sided superior sulcus tumor. The tumor was found to be invading the extrapleural space above the first rib, so the patient underwent neoadjuvant chemotherapy and radiotherapy. She was restaged and found to have a good response to therapy so she underwent thoracoscopic resection. The resection was technically difficult due to the superior sulcus location of the tumor and the fact that she had had preoperative radiation therapy, however we were able to complete the resection thoracoscopically. During the extrapleural dissection to remove the tumor from the apex, the subclavian artery was injured and the thoracoscopic management and repair of this is described during the video. This video demonstrates the application of thoracoscopic techniques to a very difficult dissection of a tumor in a difficult location. These tumors are typically resected through large posterolateral thoracotomy incisions, however we were able to perform this resection in a minimally invasive manner, with all the known associated benefits. A subclavian artery injury occurred during the dissection of the radiated field in the apex of the chest wall and we were able to avoid a large incision and successfully repair the artery via minimally invasive means. The utility and possibility of using minimally invasive techniques for complex lung resections involving the chest wall along with the ability to manage an intraoperative complication is demonstrated in this video, with good outcomes and long term results in this patient.