A bulla is defined as an air space in the lung measuring more than one centimeter in diameter in the distended state; the term giant bulla is used for bullae that occupy at least 30 percent of a hemithorax. A single giant bulla may be surrounded by normal lung tissue or may be accompanied by a number of smaller adjacent bullae. Bullectomy involves the surgical removal of one or more giant bullae to improve symptoms and respiratory function in patients with bullous emphysema. Giant bullae adversely affect respiratory physiology in several ways.
They occupy a large volume of the chest cavity and compress adjacent, more normal lung tissue. The rationale of lung volume reduction surgery in diffuse bullous emphysema is discussed separately. VATS is a less invasive procedure than open thoracotomy and has been used in conjunction with staplers, electric cautery, laser, and combinations of…
