Home-made endoloops for bullous lung disease: a case report

Various surgical techniques for bulla ablation have been used since the introduction of video-assisted thoracoscopic surgery. Endoscopic stapler resecting (Endo-GIA) is now the most common procedure for bulla ablation. Other endoscopic techniques include bulla suturing, clipping, laser ablation and electrocauterization. We present here a select report on using a "home-made" endoloop on a patient with bullous lung disease. No intraoperative morbidity was attributable to the procedure. The operating room time was 110 minutes, and ventilator support was given for 18 hours. The chest tube was removed on day 7 and the patient discharged on the ninth postoperative day uneventfully. The patient exhibited subjective improvement in his symptom preceptions during an one-month follow-up examination. A comparison of pre- and post operative functional evaluation showed increase in FEV1 (from 0.45 L to 1.02 L) during 3-month follow-up. From our experience, thoracoscopic home-made endoloop ligation is a safe and cost effective means of volume reduction surgery for bullous emphysema that interferes with optimum function of the adjacent lung parenchyma.