Siamese Twins Separated
In a surgical marathon lasting more than 90 grueling hours, eleven-month-old Siamese twins, joined at the head, were successfully separated Tuesday.
A team of 20 specialists, working around the clock in shifts, performed the delicate surgery on Nepalese twins Jamuna and Ganga Shrestha. The twins shared the same skull cavity and their brains were partially fused, making the separation especially difficult.
The surgery was initially expected to last around 36 hours, but doctors had a particularly hard time unraveling the hundreds of interwoven blood vessels. The Singapore team of doctors who operated on the girls believe that the operation was one of the most complex and difficult ever attempted.
"We didn't expect it to take so long," said Claire Ang, an anesthetist involved with the procedure.
"Happily, we had no adverse events throughout the entire five days of surgery," Dr. Keith Goh, head of the medical team, told reporters in a news conference after the surgery. "We are cautiously optimistic."
He said it was too early to know if the babies would suffer any neurological defects and said the next few days were "crucial."
The greatest risks the twins face after "such a prolonged surgery" are infection and hydrocephalus, said Dr. Benjamin Carson, a Johns Hopkins Siamese twin expert, who was a consultant for the operation. Doctors "will have a reasonable idea of the success of the operation within 48 hours of its conclusion."
Short on sleep, pepped up on caffeine, and under enormous stress, the doctors who performed the procedure were prone to mood swings. "I think the mood varied from euphoric to hysterical," Ang said. "There were moments when everybody felt the tension rising, especially with the different positioning (of the babies).
Doctors used the synthetic Gortex to replace parts of the twins' dura, a fibrous tissue layer covering the brain. Bone material mixed with polymer was used to rebuild their skulls.
Siamese twins joined at the head are very rare, occurring once in two million live births, according to Goh. Last year doctors in Australia successfully separated twins who were joined at the backs of their heads.
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