AIIMS Delhi doctors perform rare lung surgery on 4-month-old baby

In a rare medical achievement, doctors at the All India Institute of Medical Sciences (AIIMS), New Delhi, have successfully performed a highly complex lung-preserving surgery on a four-month-old infant born with a congenital lung malformation affecting both lungs. The baby recovered rapidly and was discharged just two days after the procedure.

The surgery is considered one of the youngest reported cases globally of a segment-level lung resection, or segmentectomy, in an infant, highlighting advances in paediatric minimally invasive surgery.

Baby diagnosed before birth

The child was diagnosed during pregnancy with Congenital Pulmonary Airway Malformation (CPAM), a rare developmental disorder in which parts of the lungs form abnormal cyst-like tissue instead of healthy lung tissue.

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While CPAM usually affects one lung, this infant had the condition in both lungs, making the case significantly more complicated.

Because healthy lung tissue was already limited, surgeons decided against removing an entire lung lobe. Instead, they opted for a far more delicate procedure that removed only the diseased sections while preserving as much healthy lung as possible.

Why this surgery was so challenging

The lungs are divided into lobes, which are further divided into smaller functional units known as segments. Each segment has its own airway and blood supply.

Removing an entire lobe is a relatively standard procedure. However, removing individual segments requires surgeons to carefully separate tiny blood vessels and airways located deep within the lung without damaging surrounding healthy tissue.

In this case, the surgical team removed segments 9 and 10 of the lower lobe of the baby's right lung, widely regarded as among the most technically demanding portions of the lung because of their deeply embedded blood vessels and airways.

Dr. Sandeep Agarwala, Head of the Department of Paediatric Surgery at AIIMS New Delhi, said the procedure represented a significant technical milestone.

"Segments 9 and 10 are among the most difficult to remove in the entire lung, since their vessels and airway 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."

He added that such outcomes are possible because of specialised teamwork, infrastructure and facilities available at AIIMS.

A multidisciplinary effort

The operation was led by Professor Vishesh Jain from the Department of Paediatric Surgery. A critical aspect of the surgery was selective lung ventilation, a specialised anaesthesia technique that allows one lung to continue breathing while the other is temporarily collapsed, giving surgeons a stable operating field.

The technique is especially challenging in infants because of their tiny airways. It was managed by Dr. Abhishek from the Department of Anaesthesia.

The surgery was completed without complications, and the infant remained stable throughout recovery before being discharged just 48 hours later.

Another surgery still awaits

Since the congenital malformation affects both lungs, the recent operation addressed only the diseased portion of the right lung.

Doctors plan to perform a second surgery on the left lung after the baby has grown further and recovered fully from the first operation. Until then, the child will remain under close medical supervision.

A promising option for families

Doctors say the case demonstrates that lung-preserving surgery can now be safely performed even in very young infants when the anatomy allows.

Instead of removing an entire lobe, surgeons may be able to excise only the diseased segments, helping preserve long-term lung function, an important consideration for children who have many years of growth ahead.

The AIIMS team hopes the successful outcome will encourage early diagnosis and reassure parents that highly specialised surgical options are now available for complex congenital lung disorders.