Case video report on uniportal VATS for giant bullous emphysema (GBE) with wide resection of a giant bulla in the right upper lobe

Background: Giant bullous emphysema (GBE), a severe form of chronic obstructive pulmonary disease, is characterized by large bullae that can occupy significant portions of the thorax, leading to compromised lung function and serious complications like spontaneous pneumothorax. Nowadays, this type of disease is known to be addressed in a minimally invasive through video-assisted thoracoscopic surgery (VATS), with an increasing trend towards the uniportal video-assisted thoracoscopy (U-VATS) technique due to its positive outcomes. Case Description: We report the case of a 34-year-old non-smoking male with symptomatic GBE affecting the right upper lobe (RUL) discovered by high-resolution computed tomography (HRCT), who underwent surgical treatment by U-VATS technique. The stapler line of the resection was reinforced by buttressed materials to prevent air leakage due to the fragility of lung parenchyma, therefore chemical pleurodesis was deemed unnecessary. Surgery was effective with complete right lung inflation after bulla removal. The postoperative course was uneventful, with discharge on postoperative day 4. The patient demonstrated rapid clinical improvement, with low pain, fast recovery and improved pulmonary function. Conclusions: This case supports the effectiveness of U-VATS in managing GBE, minimizing surgical trauma and enhancing outcomes. The integration of advanced surgical techniques, such as the use of reinforced staplers, plays a crucial role in optimizing patient care. Further research is warranted to assess long-term efficacy and potential advancements in thoracic surgery for GBE management.