Groundbreaking Surgery Saves the Life of Newborn at The Children’s Hospital at Saint Peter’s University Hospital

New Brunswick, N.J. - July 31, 2024 - Mariola and Artur Puchalskiwere so excited for the arrival of their baby girl, Claudia, who would be the third child in their family in East Brunswick, NJ. 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 alright but would require surgery after birth.

"I was scared when I found out my child would need surgery at only three months old. I remember crying all the way home, and then I could not eat anything for a whole week but forced myself to because I knew I had to," Puchalski recalled.
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, NJ 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.
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About The Children's Hospital at Saint Peter's University Hospital
The Children's Hospital at Saint Peter's University Hospital is a state-designated acute care children's hospital and Regional Perinatal Center sponsored by the Roman Catholic Diocese of Metuchen. The Children's Hospital at Saint Peter's provides families with access to a full range of pediatric specialties, including a nationally renowned Level IV Neonatal Intensive Care Unit, a dedicated Pediatric Emergency Department, adolescent medicine, cancer care, diabetes, orthopedics, surgery, developmental pediatrics, gastroenterology, allergy and immunology, infectious disease medicine, cardiology, nephrology, neurology, pediatric intensive care, pulmonary/sleep medicine, audiology and physical therapy. Other programs and services include Medical Genetics and Genomic Medicine, which counsels, tests and treats children with rare diseases; the Craniofacial and Neurosurgical Center, which offers corrective surgery and multidisciplinary support for children born with cleft lip, cleft palate and other facial deformities; the Dorothy B. Hersh Regional Child Protection Center, a state-designated regional Diagnostic and Treatment Center for child abuse prevention; and the Center for Diabetes Self-Management and Education, which diagnoses and treats children with diabetes and other endocrine disorders.

Saint Peter's has received Perinatal Care Certification and Level IV Maternal Levels of Care Verification from the Joint Commission and the Beacon Award for Excellence from the American Association of Critical-Care Nurses for its Neonatal Intensive Care and Pediatric Intensive Care Units. Saint Peter's University Hospital has been redesignated as a Magnet® hospital by the American Nurses Credentialing Center of the American Nurses Association for 2020-2024, making Saint Peter's one of only five hospitals worldwide at the time to receive this designation for six consecutive terms.

Visit saintpetershcs.com/childrenshospital or call 732.565.KIDS [5437].

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