ABSTRACT
No specific milestones exist in the evolution of bullectomy except for the advent of video assisted thoracic surgery (VATS). In the past posterolateral thoracotomy was usually indicated for persistent leaks after tube thoracostomy. Subsequently, during the 1970s and 1980s a tendency towards limited thoracotomies emerged, and bullae were preferably resected through small axillary thoracotomies. In the 1990s the advent of VATS introduced a radical change in the surgical approach for this disease. Different methods of producing bullae disappearance and air leakage control were implemented, such as endostapling, YAG laser, argon beam, and endo-looping. Of all of these techniques, endostapler bullae resection prevailed as the most effective and rational surgical technique.
