A 47-year-old male was admitted because of an abnormal shadow on chest X-ray. Computed tomography showed a giant bulla in the right lung. The giant bulla was resected under thoracoscopic guidance using endoscopic GIA by three puncture technique. The thoracoscope was inserted through the 5th intercostal space in the mid-axillar line. The forceps was inserted through the 5th intercostal space below the inferior angle of the right scapula. The Endo GIA was inserted through the 3rd intercostal space in the anterior axillar line. The residual lung expansion was good enough. The chest drain was removed 5 days after operation thoracoscopic surgery with Endo GIA can be useful in treatment of patients with emphysematous giant bulla.
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