Thoracoscopic pleural tenting following bullectomy to reduce postoperative air leak

Chronic obstructive pulmonary disease (COPD) is a worldwide problem and poses a significant respiratory morbidity and mortality. Surgery has a definite beneficial role in the management of COPD in the right patient. Bullectomy has been shown to improve quality of life and survival in the patients with giant pulmonary bulla. Though thoracoscopic bullectomy has significantly reduced perioperative complications, prolonged postoperative air leak remains a major complication. We hereby describe a simple technique of pleural tenting to buttress the staple line following thoracoscopic bullectomy to lower the risk of air leak.