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Updated: Jun 7, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery

Non-Intubated Video-Assisted Thoracoscopic Surgery

Published on: May 26, 2023

Awake thoracoscopic bullaplasty.

Eugenio Pompeo¹, Federico Tacconi, Luca Frasca

¹Department of Thoracic Surgery & Emphysema Center, Policlinico Tor Vergata University, Rome, Italy. pompeo@med.uniroma2.it

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery

|October 29, 2010

Summary

This summary is machine-generated.

Awake thoracoscopic bullaplasty offers a safe and effective surgical option for bullous emphysema. This procedure demonstrates significant, lasting clinical improvements in patients, enhancing quality of life.

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Area of Science:

Thoracic Surgery
Pulmonology
Anesthesiology

Background:

Standard surgical treatment for bullous emphysema involves staple excision under general anesthesia.
A novel technique, thoracoscopic bullaplasty, is now available for awake patients using epidural anesthesia.

Purpose of the Study:

To evaluate the safety and efficacy of awake thoracoscopic bullaplasty.
To assess patient satisfaction and clinical outcomes following the procedure.

Main Methods:

Prospective nonrandomized trial of 35 patients undergoing awake thoracoscopic bullaplasty.
Preoperative computed tomography for bulla volume measurement.
Postoperative assessment of patient satisfaction, oxygenation (PaO(2)/FiO(2)), and clinical measures at 6, 12, and 36 months.

Main Results:

Successful completion in 34 patients; no mortality.
Temporary perioperative changes in oxygenation and carbon dioxide levels.
Significant improvements in FEV(1), residual volume, dyspnea index, and 6-minute walk test lasting up to 36 months.
No recurrence of operated bullae observed.

Conclusions:

Awake thoracoscopic bullaplasty is well-tolerated and feasible for most patients.
The procedure leads to significant and sustained clinical improvements.
This technique provides a viable alternative to traditional surgery for bullous emphysema.