NEW DELHI: A four-month-old baby boy has become one of the youngest reported patients to undergo a rare lung-sparing keyhole surgery at AIIMS, New Delhi, after doctors removed only the diseased segments of a lung affected by a congenital malformation involving both lungs. The child recovered without complications and was discharged within two days of the operation.Doctors said the operation addressed only the affected portion of the right lung. Since the congenital malformation also involves the left lung, the child will undergo a second surgery in the coming months after further growth and recovery.The infant had been diagnosed before birth with Congenital Pulmonary Airway Malformation (CPAM), a rare condition in which part of the lung develops abnormally, forming cyst-like tissue that cannot function normally. While CPAM typically affects only one lung, the baby’s condition involves both lungs, making treatment far more complex. Removing an entire lung lobe, the standard approach in many such cases, could have significantly reduced the child’s healthy lung tissue and affected long-term lung function.Instead, the surgical team chose a far more demanding lung-preserving segmentectomy, removing only the diseased portion of the right lung while preserving the healthy tissue. The operation involved excising two segments (9 and 10) of the right lower lobe, regarded among the most technically challenging lung segments because the blood vessels and airways lie deep within the lung tissue.“Both segments are among the most difficult to remove in the entire lung since their vessels and airway are buried deep within the tissue. Performing this safely through keyhole surgery in an infant just four months old is a significant technical achievement,” said Dr Sandeep Agarwala, Head of the Department of Paediatric Surgery at AIIMS, New Delhi.The surgery was led by Prof Vishesh Jain of the Department of Paediatric Surgery. A crucial part of the procedure was selective lung ventilation, in which anaesthetists temporarily ventilate one lung while surgeons operate on the other. The technique is particularly challenging in infants because of their tiny airways and was managed by Dr Abhishek from the Department of Anaesthesia. The surgery was completed without complications, allowing the infant to be discharged just 48 hours later.