Groundbreaking surgery saves life of East Brunswick newborn

Mariola and Artur Puchalski were so excited for the arrival of their baby girl, Claudia, who would be the third child in their family in East Brunswick. However, when Mariola went in for a routine 20-week ultrasound, doctors discovered abnormal tissue in her baby’s right lung. Known as a congenital pulmonary airway malformation (CPAM), the abnormal tissue is usually benign, but it can continue to grow and potentially cause life-threatening issues. Mariola felt both shock and disbelief when she first heard the news. She was then referred to a maternal-fetal medicine specialist who informed her that her baby would likely be all right but would require surgery after birth.
 
Puchalski was eventually connected to L. Grier Arthur III, MD, FACS, chair, Department of Surgery at Saint Peter’s University Hospital and surgeon-in-chief at The Children’s Hospital at Saint Peter’s University Hospital. Dr. Arthur explained the intricacies of thoracoscopic surgery, which involved removing the lower lobe of Claudia’s right lung through small incisions, avoiding the need for a large thoracotomy or invasive chest incision, which can lead to complications like scoliosis.
 
“The surgery to correct CPAM is intricate. The lobe is connected directly to the heart via the pulmonary artery and veins, and the bronchus is connected to the trachea, or windpipe. All these structures have to be disconnected safely to remove the lower lobe,” said Dr. Arthur.
 
This case marks the first time such procedure has been performed thoracoscopically at The Children’s Hospital at Saint Peter’s University Hospital, a member of Saint Peter’s Healthcare System, demonstrating the hospital’s commitment to innovative prenatal and postnatal care.
 
“When I met with Dr. Arthur, he explained everything clearly, including what CPAM is and the details of the procedure. I felt better after meeting him because I knew we had finally found a doctor who would help us. He said that after the surgery, my baby would develop like any other child, which gave me hope,” said Puchalski.
 
After the procedure, Claudia stayed at the hospital for a week. She has since returned to her home in East Brunswick and made a remarkable recovery.
 
“My baby is almost a year old, and she is doing very well now. You can’t tell that she had surgery, except for three small scars from the incisions. She stands up by herself, is learning how to walk, and loves playing with her two older siblings,” Puchalski said.

“It’s important to address lung lesions such as these because these lesions can make it harder for the lungs to clear bacteria appropriately leading to infections. Occasionally they can be life-threatening from an oxygen and ventilation standpoint, although thankfully in Claudia’s case this was not an issue,” said Dr. Arthur.
 
Thoracoscopic lobectomy is a highly complex case that removes the affected lobe of a lung and leaves the normal lung lobes behind. This used to be done with an open thoracotomy that caused patients to have significant pain, often requiring narcotics and causing scoliosis associated with the open surgery. Now patients typically go home with minimal pain and there is no risk of developing scoliosis, according to Dr. Arthur. Their surgical scars are so small that many people will not notice them.
 
Claudia’s case was significant because such procedures are usually performed only several times a year and at large urban medical centers. Dr. Arthur’s expertise allows parents to opt for lifesaving surgery here in New Jersey instead of travelling to major cities like Philadelphia, New York or Boston which requires extra travel, time, and expense during an already stressful time.
 
The Children’s Hospital at Saint Peter’s University Hospital has a long-standing reputation for comprehensive maternal care, including the quality of its pediatric intensive care unit and Level IV neonatal intensive care unit. Dr. Arthur’s surgical expertise in combination with his highly trained clinical staff means local parents now have access to world-class care close to home.
 
To learn more about pediatric surgery at The Children’s Hospital at Saint Peter’s University Hospital, visit saintpetershcs.com/pedssurgery