- Giant bullae are abnormal air-filled spaces within the lung parenchyma that occupy more than one third of the hemithorax. The best surgical candidates have isolated bullae, dyspnea, and collapsed but otherwise normal underlying lung. - Preoperative evaluation includes pulmonary function testing, CT scan, and sometimes ventilation-perfusion scanning to assess the contribution of the bulla to lung function. - Surgical techniques to remove the bulla include stapled bullectomy, excision, ligation, and endo-cavitary drainage via thoracoscopy, thoracotomy, or sternotomy. Most patients experience symptomatic and functional improvement, though the duration depends on emphysema progression.