Bullectomy

What this procedure is

A bullectomy is a surgical procedure to remove large, air-filled sacs called bullae from the lungs. These sacs are pockets of air that have become trapped and can no longer help your body take in oxygen. When these sacs get very large, they can press against the healthy parts of your lung, making it harder for you to breathe.

During the procedure, a surgeon removes these non-working air pockets. This is often done using a minimally invasive method called Video-Assisted Thoracoscopic Surgery (VATS). This technique uses small incisions and a tiny camera to guide the surgeon. In some cases, your clinician may recommend a traditional surgery with a larger incision if it is the best option for your specific health needs.

What it treats or fixes

This procedure is primarily used to treat complications from lung conditions like emphysema or Chronic Obstructive Pulmonary Disease (COPD). Over time, these conditions can cause the tiny air sacs in the lungs to break down and form larger, useless spaces. A bullectomy aims to help the lungs work more efficiently.

The main goals of the procedure include:

• Improving breathing: By removing the large sacs, the healthy parts of your lung have more room to expand and take in air.
• Reducing discomfort: Large bullae can sometimes cause chest pain or a feeling of pressure.
• Preventing a collapsed lung: If a bulla bursts, it can cause air to leak into the space around the lung, leading to a collapse (pneumothorax). Removing them helps lower this risk.

How common it is & where it's done

While many people manage lung conditions with medication or oxygen therapy, a bullectomy is a well-established option for those with "giant bullae"—sacs that take up a third or more of the space in the chest cavity. It is considered a specialized surgery rather than a routine one.

The procedure is performed in a hospital by a thoracic surgeon, who is a doctor trained specifically in operations involving the chest and lungs. After the surgery, patients typically stay in the hospital for several days so the medical team can monitor their recovery and ensure the lungs are healing properly. Your clinician may discuss this option if your symptoms are significantly affecting your quality of life.

Recovery: What to Expect

After a bullectomy—the removal of a large, non-functioning air sac (bulla) in the lung—you will likely stay in the hospital for several days. Your clinician may use a chest tube, which is a small, flexible tube placed in the chest to help drain air and fluid while the lung heals. This tube is usually removed once the lung has fully expanded and the drainage stops.

To help your lungs stay clear and strong, your care team will encourage you to:

• Walk short distances as soon as you are able to move safely.
• Use a breathing device called an incentive spirometer to practice deep breaths.
• Manage any discomfort with medications provided by your surgical team.

Risks & Possible Complications

Every surgery has risks, and your surgical team works to minimize them. The most common issue after this procedure is a prolonged air leak. This happens when air continues to escape from the lung surface into the chest cavity for more than a few days, which may mean the chest tube stays in place a bit longer than expected.

Other possible complications include:

• Infection or pneumonia (a lung infection).
• Bleeding during or after the procedure.
• Heart rhythm changes.

Your clinician may ask you to call if you notice a new fever, sudden chest pain, or if you feel more short of breath than usual during your recovery at home.

Outcomes & Long-Term Results

The main goal of a bullectomy is to help you breathe more easily. When a large bulla is removed, it gives the healthier parts of your lung more room to expand and work properly. Many patients find they can be more active and have less shortness of breath after they have fully healed from the procedure.

While the surgery does not cure underlying lung conditions like emphysema, it can significantly improve your daily comfort. Long-term success often depends on following your clinician's advice, such as avoiding smoking and participating in pulmonary rehabilitation (a guided exercise and education program) if recommended.

Emotional Support & Reassurance

It is completely natural to feel anxious about having surgery on your lungs. Remember that your medical team performs these procedures to help you feel better and stay more active. They are there to answer your questions and guide you through each step of the healing process.

Focusing on small, daily goals during your recovery can help you feel more in control. If you feel overwhelmed or worried, your clinician may suggest support groups or resources to help you manage the emotional side of living with a chronic lung condition.

Why doctors recommend it

A bullectomy is a surgery to remove a "bulla." A bulla is a large, thin-walled air sac that forms on the lung. These sacs do not help you breathe; instead, they take up space and can press against healthy lung tissue, making it harder for your lungs to expand and take in oxygen.

Your clinician may recommend this procedure if a bulla becomes very large—often taking up one-third or more of the space in your chest. When these sacs reach this size, they are called "giant bullae." Doctors often suggest surgery if you are experiencing significant shortness of breath or if the bulla is interfering with your daily activities and quality of life.

Urgent vs planned treatment

In many cases, this is a planned surgery. Your medical team may monitor the bulla over time using imaging tests like CT scans. If the bulla is growing or your lung function tests show that your breathing is getting worse, they may schedule the surgery to prevent future complications.

Sometimes, the surgery is more urgent. This can happen if a bulla ruptures (pops), which can lead to a collapsed lung, also known as a pneumothorax. If you have a history of multiple lung collapses, or if a bulla becomes infected or starts to bleed, your clinician may decide that surgery needs to happen sooner to stabilize your breathing and protect the lung.

Goals of treatment

The primary goal of a bullectomy is to help you breathe more easily. By removing the non-working air sac, the healthy parts of your lung have more room to fill up with air. This can improve your "exercise tolerance," which is your ability to walk or move without getting winded as quickly.

Other goals of the treatment include:

• Reducing discomfort: Relieving chest pain caused by the pressure of the bulla against the chest wall.
• Preventing emergencies: Lowering the risk of a sudden lung collapse in the future.
• Improving lung function: Helping the diaphragm (the main muscle used for breathing) work in a more natural, efficient way.

Who may benefit

A bullectomy is a surgery to remove large, permanent air sacs called bullae. These sacs can form when the tiny air sacs in the lungs are damaged, often due to conditions like COPD or emphysema. When these bullae get very large—sometimes taking up a third or more of the space around the lung—they can press on healthy lung tissue and make it hard to breathe.

Your clinician may suggest this procedure if you have a large bulla that is causing significant shortness of breath or chest pain. It is also often considered for people who have experienced a collapsed lung (pneumothorax) because a bulla popped. By removing the useless air sac, the remaining healthy lung tissue has more room to expand, which may help you breathe more easily and stay more active.

When it may not be the right option

While this surgery can be very helpful for some, it is not the right choice for everyone. If the bullae are small or are not causing any symptoms, your care team may choose to monitor them instead of performing surgery. The procedure is generally most effective when there is one large, clear bulla rather than many small ones scattered throughout both lungs.

Your clinician may also advise against surgery if you have other serious health concerns, such as severe heart disease or very poor overall lung function, which could make the recovery process difficult. Additionally, because smoking can cause new bullae to form and slow down healing, many surgical teams require patients to stop smoking for a period of time before the procedure.

Questions to ask your care team

Deciding on surgery is a big step. It is helpful to have a list of questions ready for your next appointment to help you feel more comfortable with the plan. You might consider asking:

• How much of my lung is currently being affected by these air sacs?
• How much improvement in my breathing can I realistically expect after surgery?
• What are the specific risks for me based on my health history?
• Will this be done as a "keyhole" surgery (minimally invasive) or an open surgery?
• What does the recovery process look like, and how soon can I return to my normal activities?
• Are there other treatments we should try before considering surgery?

In the procedure room

When you arrive for your surgery, you will be welcomed by a specialized team of healthcare professionals. This team usually includes your surgeon, an anesthesiologist, and several nurses. You will be helped onto a padded operating table and positioned comfortably, often on your side or back, depending on which part of the lung is being treated.

The room will contain advanced equipment to monitor your health and help the surgeon see inside your chest. The environment is kept clean and controlled to ensure your safety throughout the process.

High-level steps

The main goal of a bullectomy is to remove bullae, which are large, thin-walled air sacs that have formed on the lung. These sacs take up space but do not help you breathe. Your clinician may use one of two main methods:

• VATS (Video-Assisted Thoracoscopic Surgery): This is a minimally invasive approach where the surgeon makes a few small incisions (cuts) and uses a tiny camera to see inside.
• Thoracotomy: In some cases, a larger incision may be needed to allow the surgeon to reach the area directly.

Once the bullae are reached, the surgeon carefully removes them. The remaining healthy lung tissue is then sealed using surgical staples or stitches to prevent air from leaking out.

Anesthesia and pain control

You will receive general anesthesia, which means you will be in a deep sleep and will not feel any pain during the procedure. A breathing tube will be used to help you breathe while you are asleep.

To help with comfort after you wake up, your care team may use local numbing medicine at the incision sites. They might also use a "nerve block," which is an injection that helps keep the chest area numb for several hours or days after the surgery to manage soreness.

Monitoring and safety steps

Your safety is the top priority. Throughout the surgery, the team continuously monitors your heart rate, blood pressure, and oxygen levels. They also check that your lungs are inflating properly after the damaged sections are removed.

Before finishing, the surgeon usually places a chest tube. This is a thin, flexible tube that stays in the chest for a short time. It is used to drain any extra air or fluid and helps the lung stay fully expanded as it begins to heal.

Immediately after the procedure

You will wake up in a recovery room where nurses will monitor you closely as the anesthesia wears off. You may feel groggy or have a slightly sore throat from the breathing tube. It is normal to feel some pressure or soreness in your chest where the incisions were made.

The chest tube will be connected to a container to monitor drainage. Your care team will encourage you to take deep breaths or use a small device called a spirometer to help keep your lungs clear and healthy during the first few hours of recovery.

Typical procedure length

A bullectomy typically takes between 1 and 3 hours to complete. The exact time can vary depending on the size and number of bullae being removed, as well as the specific surgical technique your clinician chooses for your care.

Common approaches (open vs minimally invasive)

Surgeons have different ways to reach the lungs to remove bullae (large air pockets). The choice often depends on the size of the bulla, your overall health, and whether you have had chest surgery before.

• Video-Assisted Thoracoscopic Surgery (VATS): This is the most common approach. The surgeon makes a few small cuts (incisions) in the chest. A tiny camera and special tools are inserted through these cuts to find and remove the bulla. Because the cuts are small, recovery is often faster and less painful compared to open surgery.
• Robotic-Assisted Surgery: Similar to VATS, this uses small incisions and a camera. The surgeon controls robotic arms to perform the procedure with high precision. This is a newer option and may not be available at all hospitals.
• Open Thoracotomy: In this approach, the surgeon makes one larger incision between the ribs to view the lung directly. This is typically reserved for complex cases, such as when the bullae are extremely large (giant bullae), if there is a lot of scar tissue inside the chest, or if a minimally invasive attempt needs to be converted to an open procedure for safety.

Partial vs total

The main goal of a bullectomy is to remove the air pocket while saving as much healthy lung tissue as possible. This helps the lung work better after surgery.

In most cases, the surgeon performs a targeted removal of just the bulla. They may use a stapling device that cuts the bulla off and seals the lung tissue at the same time. This allows the remaining healthy lung to expand and fill the chest cavity properly.

However, if the damage to the lung is widespread or if the bulla is part of a very damaged section of the lung, a larger removal may be necessary. In these instances, the surgeon might remove a specific segment or an entire lobe of the lung (lobectomy). This is less common for simple bullectomy but may be chosen if the tissue surrounding the bulla is too unhealthy to save.

Revision or repeat procedures

For most patients, one surgery is enough to treat the problem. However, it is possible for new bullae to form over time, or for air leaks to return. If this happens, a revision (repeat) surgery might be discussed to address the new issues.

To lower the risk of the problem coming back, surgeons often perform an additional step during the initial bullectomy called pleurodesis. This involves treating the lining of the chest wall so the lung sticks to it. This helps prevent the lung from collapsing again if a new air leak develops in the future.

Tests and imaging that may be done

To plan your surgery safely, your healthcare team needs a clear picture of your lungs. They will look at the size and location of the bullae (large air blisters) and check how well the rest of your lung tissue is working.

• Chest X-ray: This provides a basic view of the lungs to identify large air pockets or signs of a collapsed lung.
• CT Scan: This imaging test creates detailed pictures of the chest. It is often considered the most important tool for measuring the bullae and checking the health of the surrounding lung tissue.
• Pulmonary Function Tests (PFTs): You may be asked to breathe into a machine to measure how much air your lungs can hold and how quickly you can move air in and out.
• Blood flow and gas tests: Your clinician may order a ventilation/perfusion (V/Q) scan or blood gas tests to see how well oxygen is moving into your bloodstream.

Medication adjustments

Your surgical team will review your current list of prescriptions, over-the-counter medicines, and supplements. They will tell you which ones to continue and which ones to pause.

• Breathing medications: If you take bronchodilators or steroids for conditions like COPD, your doctor may adjust your dosage to ensure your lungs are as clear as possible before surgery.
• Antibiotics: If you have a respiratory infection or significant mucus, your clinician may prescribe antibiotics to treat it before the operation.
• Smoking cessation: If you smoke, stopping is a critical part of preparation. Your care team will strongly urge you to quit, as this helps lower the risk of complications and improves healing.
• Blood thinners: You may need to stop taking blood-thinning medicines for a short time to reduce bleeding risks. Only stop medicines if your clinician instructs you.

Day-before and day-of instructions

Following the hospital’s instructions helps ensure your surgery can proceed as scheduled. Most procedures are done under general anesthesia, so preparing your body is important.

• Fasting: You will usually be told not to eat or drink anything after midnight the night before your surgery. This prevents food from entering your lungs while you are asleep.
• Hygiene: Your team may ask you to shower with a special antibacterial soap the night before or the morning of the surgery to lower the risk of infection.
• What to bring: Bring your insurance card, ID, and a list of your medications. Leave valuables like jewelry at home.
• Plan for home: You will not be able to drive yourself home after anesthesia. Arrange for a friend or family member to pick you up and stay with you during your initial recovery.

General surgical risks

As with any operation, there are standard risks involved. These generally include reactions to anesthesia, bleeding, or the possibility of an infection at the incision site.

Because surgery involves resting in bed for recovery, there is a small risk of developing blood clots in the legs. Your care team will take steps to prevent this, such as encouraging movement as soon as it is safe or using compression stockings.

Procedure-specific complications

Bullectomy is focused on the lungs, so your surgeon will monitor for specific side effects related to breathing and the chest cavity. While serious complications are not common, possible issues include:

• Prolonged air leak: This is the most common complication. It happens when air continues to escape from the lung into the chest space for more than seven days after surgery.
• Collapsed lung: In some cases, air may collect around the lung again (pneumothorax), preventing it from inflating fully.
• Heart and lung stress: Some patients may experience a temporary irregular heartbeat (atrial fibrillation) or develop a lung infection like pneumonia.

How complications are treated

Most complications are treatable, and your medical team will monitor you closely to catch them early. Treatment depends on the specific issue:

• Managing air leaks: If an air leak occurs, the chest tube placed during surgery is usually left in longer. This allows the lung to re-expand and the leak to seal on its own.
• Medication: Antibiotics are prescribed if an infection develops. If you experience an irregular heartbeat, your clinician may provide medication to help return your heart rhythm to normal.
• Ongoing monitoring: Your doctor will likely use chest X-rays to ensure the lung stays inflated and the surgical site heals properly.

Pain control medicines

Managing discomfort is a key part of recovery after a bullectomy. Your clinician may use a combination of methods to keep you comfortable. This often starts in the hospital with analgesics (pain-relieving medicines) delivered through an IV or a PCA pump, which allows you to press a button to release a set amount of medicine when needed.

Common options include:

• Acetaminophen or NSAIDs: These help reduce mild to moderate pain and swelling.
• Opioids: These are stronger medicines used for short-term relief of more intense pain.
• Local anesthetics: These may be injected near the surgical site or through an epidural (a small tube in the back) to block pain signals from the nerves.

Your care team will tailor the plan to your specific needs. It is important to mention any history of allergies or sensitivities to pain medications. Some of these medicines can cause side effects like sleepiness or constipation, so your clinician will monitor you closely during your stay.

Antibiotics

Antibiotics are medicines used to prevent or treat infections caused by bacteria. Because a bullectomy involves surgery on the lung, your clinician may give you prophylactic antibiotics (preventative medicine) just before the procedure begins. This helps lower the risk of an infection at the surgical site or in the lungs.

In some cases, you might continue taking antibiotics for a short time after the procedure while you recover. It is important to tell your doctor if you have ever had an allergic reaction to an antibiotic, such as a rash or hives. Following the full schedule of these medicines as prescribed helps ensure they work effectively to protect your health.

Blood thinners and clot prevention

After surgery, being less active can increase the risk of developing blood clots in the legs, a condition called deep vein thrombosis (DVT). To help prevent this, your clinician may prescribe anticoagulants, which are commonly known as blood thinners.

Commonly used medicines include:

• Heparin: This is often given as a small injection under the skin while you are in the hospital.
• Low-molecular-weight heparin: This is another type of injectable medicine used to keep the blood from clotting too easily.

These medicines help keep your blood flowing smoothly while you are resting. Your care team will check for any signs of unusual bruising or bleeding, which can be a side effect of these treatments. They will also encourage you to sit up and walk as soon as it is safe, as movement works with the medicine to keep your circulation healthy.

Emergency warning signs

While recovery is usually steady, certain symptoms require immediate attention. Call 911 or go to the nearest emergency room if you experience sudden or severe changes in your condition.

• Severe trouble breathing: Struggling to catch your breath, or feeling like you are suffocating.
• Signs of low oxygen: Your lips, fingernails, or skin turn blue or gray.
• Sudden chest pain: Sharp or crushing pain in the chest that does not go away.
• Coughing up blood: Coughing up bright red blood (more than just a streak in mucus).

Call your surgeon or clinic if…

Some symptoms may not be life-threatening emergencies but still need prompt medical treatment to prevent complications like infection or air leaks. Contact your healthcare provider if you notice:

• Fever or chills: A temperature higher than 100.4°F (38°C).
• Wound changes: Redness, warmth, increasing swelling, or pus draining from your incision sites.
• Uncontrolled pain: Pain that keeps getting worse or is not relieved by your prescribed medication.
• New swelling: Puffiness in the neck or face, or a “crunchy” feeling under the skin when you press on it (which may indicate air trapped under the skin).

Expected vs concerning symptoms

Recovering from a bullectomy takes time. Knowing the difference between normal healing and potential problems can help you stay calm.

What is usually expected:

• Mild to moderate soreness: You will likely feel pain or stiffness around the incision sites and where the chest tube was placed. This should improve gradually.
• Fatigue: Feeling tired and needing extra rest is normal as your body heals.
• Shortness of breath with activity: You may get winded easily when walking or moving around, but this should slowly get better.

What is concerning:

• Worsening breathlessness: If you feel short of breath while resting or if it gets worse instead of better, this could be a sign of a collapsed lung or fluid buildup.
• Clicking or grating sensations: Feeling movement or hearing clicking sounds in your chest bone (sternum) or ribs.
• Leg swelling: Pain, redness, or swelling in one leg, which could be a sign of a blood clot.

Non-surgical treatments

Before suggesting surgery, your clinician may recommend medical treatments to manage your symptoms. These treatments do not remove the bullae (large, air-filled sacs in the lungs), but they can help you breathe more easily and protect your lung health. Medical management is often the first step for people with underlying lung conditions like emphysema.

• Smoking cessation: Stopping smoking is often the most important step to prevent bullae from getting larger and to protect the rest of your lung tissue.
• Medications: You may be prescribed bronchodilators (medicines that open the airways) or inhaled steroids to reduce swelling and improve airflow.
• Pulmonary rehabilitation: This is a guided exercise and education program designed to improve your lung strength and overall stamina.
• Preventative care: Staying up to date on flu and pneumonia vaccines helps prevent infections that could cause further lung damage.

Watchful waiting

If your bullae are small and are not causing significant shortness of breath, your clinician may suggest "watchful waiting." This means monitoring the condition closely rather than performing surgery right away. This approach is common when the bullae are not interfering with your daily activities or causing complications.

During this time, you will likely have regular follow-up appointments. Your care team may use imaging tests, such as chest X-rays or CT scans, to see if the air sacs are growing or if they are pressing against healthy lung tissue. If the bullae remain stable and your symptoms do not get worse, surgery may not be necessary.

When surgery becomes the best option

Surgery is usually considered when the bullae begin to cause serious problems or take up a large amount of space in the chest. A common guideline clinicians use is when a bulla fills more than 30% to 50% of the space around the lung. At this size, the air sac can crowd the healthy parts of the lung, making it very hard to breathe deeply.

Your clinician may recommend a bullectomy if you experience certain complications, such as:

• Pneumothorax: This occurs when a bulla ruptures, causing air to leak into the space around the lung and leading to a collapsed lung.
• Repeated infections: If the air sacs become frequently infected, surgery may be needed to prevent recurring illness.
• Severe symptoms: If shortness of breath or chest pain becomes disabling and does not improve with medicine, removing the bullae can allow the remaining healthy lung tissue to expand and function more effectively.

Hospital services that commonly perform this surgery

Bullectomy is typically performed in hospitals that have a Thoracic Surgery department. These surgeons specialize in operations on the chest and lungs. Because this surgery involves the respiratory system, you will likely interact with the Pulmonology department, which consists of doctors who specialize in lung diseases and long-term lung health.

During the procedure, a specialized Anesthesiology team is required to manage your breathing while the surgeon works on the lung. After the surgery, Respiratory Therapy services are often used to help you practice deep breathing and use tools that keep your lungs clear during recovery. Your clinician may also coordinate with Radiology for imaging, such as X-rays or CT scans, to monitor your progress.

Patient resources and support services

Many hospitals offer Pulmonary Rehabilitation programs. These services provide a safe environment to exercise and learn breathing techniques that can improve your quality of life after a bullectomy. These programs are often led by a team of specialists who understand the challenges of living with lung conditions.

If you currently smoke, your hospital may provide Smoking Cessation resources. Quitting smoking is one of the most important steps you can take to help your lungs heal and prevent new bullae (large air sacs) from forming. Additionally, Social Work or case management services can help you arrange for any medical equipment or home care you might need once you are discharged.

Questions for choosing where to have surgery

When choosing a facility for a bullectomy, you may want to ask your clinician or the hospital staff the following questions:

• How many bullectomy procedures does the surgical team perform each year?
• Does the hospital offer minimally invasive options, such as Video-Assisted Thoracoscopic Surgery (VATS), which uses small incisions and a camera?
• Is there a dedicated recovery unit for patients who have had chest or lung surgery?
• What kind of pulmonary rehabilitation or physical therapy is available at this location?
• Will I have access to a respiratory therapist throughout my hospital stay to help with my breathing exercises?

Conditions commonly treated by this procedure

A bullectomy is a surgery used to remove large, permanent air pockets in the lungs called bullae. These pockets can develop when the tiny air sacs in the lungs are damaged. When these pockets become very large, they can press on healthy lung tissue and make it harder to breathe. Your clinician may recommend this procedure to help improve lung function or prevent complications.

• Emphysema: This is a common part of chronic obstructive pulmonary disease (COPD) where the lung's air sacs are destroyed, often leading to the formation of bullae.
• Pneumothorax: This is the medical term for a collapsed lung. It can happen if a bulla bursts and leaks air into the space around the lung.
• Giant Bullae: These are air pockets that take up more than one-third of the space in one side of the chest, often causing significant pressure on the rest of the lung.
• Bullous Lung Disease: This refers to the presence of multiple large air spaces within the lungs that may interfere with normal breathing.

Related symptoms people search for

The symptoms associated with bullae can range from mild to severe. They often develop slowly over time, though some symptoms can appear suddenly if a lung collapses. Your clinician may evaluate these symptoms to determine if the air pockets are affecting your overall health.

• Shortness of breath: This is a common symptom, often becoming more noticeable during exercise or daily activities.
• Chest discomfort: You may feel a sense of tightness or pressure in your chest. Sudden, sharp pain can sometimes indicate that an air pocket has ruptured.
• Reduced exercise tolerance: You might find that you get tired more easily or cannot keep up with activities you used to do.
• Chronic cough: A persistent cough can be associated with the underlying lung damage that causes bullae to form.

Evidence overview

Bullectomy is a recognized surgical procedure used to treat giant bullae—large air pockets that form in the lung tissue. These air pockets can press against healthy parts of the lung, making it harder to breathe. Medical evidence suggests that removing these large sacs allows the compressed lung tissue to re-expand, which can improve breathing function and reduce shortness of breath.

Surgeons often use a minimally invasive approach called Video-Assisted Thoracoscopic Surgery (VATS). Clinical experience and studies generally show that this technique is effective and may lead to less pain and faster recovery compared to traditional open chest surgery. However, the best approach depends on the size and location of the bulla.

Safety notes and individualized care

While bullectomy can improve quality of life for the right candidates, it is a major surgery with potential risks. Your clinical team will evaluate your specific situation to determine if the benefits outweigh the risks. Common safety considerations include:

• Air leaks: It is possible for air to leak from the area where the bulla was removed. This is a known complication that is usually managed with a chest tube until the lung heals.
• Infection and bleeding: As with any surgery, there are standard risks of infection or bleeding, which the medical team monitors closely.
• Heart and lung stress: The procedure places stress on the heart and respiratory system, so your doctor will check your heart health and breathing capacity beforehand.

This surgery is not for everyone. It is typically reserved for patients who have a giant bulla that takes up a significant amount of space (often defined as more than one-third of the chest cavity) or for those who experience complications like a collapsed lung (pneumothorax). If a patient has severe, widespread emphysema in the rest of the lung, surgery may be less effective or considered too risky.