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A four-month-old boy in New Delhi underwent a rare minimally invasive lung-sparing surgery. Surgeons removed only the affected areas of the lung, which suffered from a congenital anomaly affecting both lungs. The child recovered without complications and was discharged two days after the procedure.

Diagnosis and Complexity of the Case

Medical staff reported that the operation was aimed exclusively at the affected part of the right lung. Since the congenital anomaly also affected the left lung, the child will undergo a second operation in the coming months after further growth and recovery.

Before the baby's birth, Congenital Pulmonary Airway Malformation (CPAM) was diagnosed—a rare condition where part of the lung develops abnormally, forming cystic tissue that does not function normally. Although CPAM usually affects only one lung, this child's condition was complicated by involvement of both lungs, which significantly complicated the treatment.

Choice of Surgical Technique

Instead of the standard approach, which would have involved removing an entire lobe of the lung and could have substantially reduced healthy lung tissue and affected long-term function, the surgical team opted for a much more complex lung-sparing segmentectomy. Only the diseased part of the right lung was removed.

The operation involved excising two segments (9 and 10) of the lower lobe of the right lung. These segments are considered among the most technically challenging because the blood vessels and airways are located deep within the lung tissue.

Technical Aspects of the Operation

Dr. Sandeep Agarwal, head of the Pediatric Surgery Department at AIIMS, New Delhi, noted that 'both segments are among the most difficult to remove throughout the lung because their vessels and airways are buried deep in the tissue. Performing this procedure safely via minimally invasive surgery on a four-month-old infant is a significant technical achievement.'

The operation was led by Professor Vishesh Jain from the Pediatric Surgery Department. A crucial part of the procedure was selective lung ventilation, during which anesthesiologists temporarily ventilated one lung while surgeons worked on the other. This technique is particularly difficult when working with infants due to their tiny airways, and it was performed by Dr. Abhishek from the Anesthesiology Department. The operation concluded without complications, allowing the infant to be discharged after only 48 hours.