Nonintubated Thoracoscopic Pneumonectomy for Bullous Emphysema.

Thoracoscopic pneumonectomy without tracheal intubation has not been reported. We describe a woman with severe bullous emphysema of the right upper lobe and hypoplasia of the remaining lung lobes who underwent thoracoscopic pneumonectomy using a nonintubated anesthetic technique of internal intercostal nerve block, vagal block, and targeted sedation. The successful results in this patient suggest that nonintubated thoracoscopic pneumonectomy is technically feasible and can be used in a specific group of patients.