Related Experiment Video
Updated: Apr 26, 2026
Robotic-assisted Left Pneumonectomy For Vanishing Lung Syndrome
Published on: January 23, 2026
Infant with bilateral pulmonary sequestrations with portal venous drainage excised by video-assisted thoracic surgery
Punam P Parikh1, Jun Tashiro1, Veer Chahwala1
1The DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida.
Insights
Bilateral pulmonary sequestration (PS), rare congenital anomalies, can involve unique portal vein drainage. Surgical excision via video-assisted thoracic surgery (VATS) offers an effective treatment option.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Anomalies
Background:
- Pulmonary sequestration (PS) is a rare congenital anomaly with potential severe complications like infections and hemoptysis.
- Surgical excision is the standard treatment for PS, even in asymptomatic cases, due to associated risks.
Observation:
- An infant presented with bilateral PS: intralobar on the right and extralobar on the left.
- Prenatal screening identified both PS, with unique venous drainage into the portal vein for both lesions.
- Surgical resection was successfully performed using video-assisted thoracic surgery (VATS) at 14 months of age.
Findings:
- Pulmonary sequestration can exhibit unusual vascular connections, such as venous drainage into the portal system.
- Video-assisted thoracic surgery (VATS) is a feasible and effective minimally invasive approach for bilateral pulmonary sequestration.
- Successful VATS resection requires meticulous preoperative planning and skilled surgical execution.
Implications:
- This case highlights the importance of recognizing atypical venous drainage patterns in pulmonary sequestration.
- VATS provides a less invasive alternative to bilateral thoracotomies for complex bilateral PS cases.
- Experienced thoracoscopic surgeons can achieve favorable outcomes with VATS for pulmonary sequestration.
Introduction:
Bilateral pulmonary sequestrations are rare congenital anomalies. Despite its benign nature, the potential complications of pulmonary sequestration (PS) are significant, including recurrent pulmonary infections, hemoptysis, congestive heart failure, and malignant potential. Therefore, the main treatment is surgical excision, even for patients with asymptomatic PS.
Case:
We present an infant in whom an intralobar PS of the right lung and an extralobar PS of the left lung were diagnosed on prenatal screening ultrasonography. Both were found to have venous drainage into the portal vein. Surgical excision was performed via video-assisted thoracic surgery (VATS) at 14 months of age.
Conclusion:
PS may present with unique vascular connections, including venous drainage into the portal vein. VATS resection for pulmonary sequestration is feasible and effective as an alternative to bilateral thoracotomies, in the setting of extensive preoperative planning and performance by an experienced thoracoscopic surgeon.
