AIIMS successfully operate on infant with congenital lung malformation

Doctors at AIIMS Delhi have successfully performed a rare and technically demanding lung-preserving surgery on a four-month-old infant born with a congenital lung malformation affecting both lungs, hospital authorities said. The child was discharged just two days after the operation, they said.

The procedure — a segment-level lung resection or segmentectomy in an infant — on one of the youngest patients is among the rarest reported cases of its kind and highlights the advanced paediatric surgical care available at the premier institute, authorities added.

The surgery was performed on the infant’s right lung, while another one on the left lung will be scheduled after a few months, according to doctors.

The baby was diagnosed before birth with congenital pulmonary airway malformation (CPAM), a condition in which part of the lung develops abnormally during pregnancy, forming cyst-like tissue that cannot function like healthy lung tissue.

Doctors said the case was particularly challenging because the malformation involved both lungs, unlike the more common presentation affecting only one lung.

Removing an entire lung lobe would have significantly reduced the child’s future lung capacity, they said. The surgical team therefore opted for a lung-preserving approach by removing only the diseased segments from the right lung.

Each lung is divided into smaller functional units called segments, each with its own airway and blood supply. While removal of an entire lobe is relatively straightforward, segmentectomy requires meticulous dissection of deeply placed blood vessels and airways while preserving the surrounding healthy lung tissue.

In this case, surgeons removed segments 9 and 10 of the lower lobe of the right lung, considered among the most technically difficult lung segments to access because of their deeply situated blood vessels, the hospital statement said.

“Segments 9 and 10 are among the most difficult to remove in the entire lung, since their vessels and airways are buried deep within the tissue, far from the surface. Performing this safely through keyhole surgery in an infant just four months old is a significant technical achievement,” Dr Sandeep Agarwala, Head, Department of Pediatric Surgery, AIIMS Delhi, said.

Outcomes like this are only possible because of teamwork, and because of the dedicated healthcare workers at AIIMS, whose infrastructure and facilities are well suited to conducting this kind of complex, lung-preserving pediatric surgery,” he said. The surgery was led by Professor Dr Vishesh Jain of the Department of Pediatric Surgery.

Doctors said a key factor behind its success was selective lung ventilation, in which the anaesthesia team ventilated one lung while allowing the other to remain still for surgery — a highly demanding technique in infants because of their tiny airways.

The anaesthesia was managed by Dr Abhishek from the Department of Anaesthesia, the statement said.

The operation was completed without complications, and the infant was discharged in stable condition after two days.

Doctors said the surgery addressed only the affected portion of the right lung. Since the malformation also involves the left lung, the child will undergo a second surgery after a few months, once adequate recovery and growth have taken place.

They said the case demonstrates that in selected infants with congenital lung malformations, removing only the diseased lung segments instead of an entire lobe is feasible, helping preserve lung function while offering good long-term outcomes.