We report herein the case of the 71-year-old man with lung cancer and pulmonary emphysema requiring supplementary oxygen at 21/min by nasal cannula for whom thoracoscopic wedge resection of an adenocarcinoma in his left lower lobe was successfully performed. During the same procedure, thoracoscopic laser ablation of pulmonary bullae was also carried out. There were no postoperative complications, and the patient is currently well 12 months following surgery without any evidence of local or regional recurrence, or distant metastasis. His severe dyspnea on exertion improved, and he no longer requires supplementary oxygen.