Narayana Health City has successfully separated conjoined twins. The twins : six month old James and John are back to their playful self after the corrective surgery. They hailed from Nigeria and were omphalopagus twins, that is they were joined at the upper part of their abdomen.
The department of pediatric surgery at NH Bangalore has had experience of treating several pairs of conjoined twins. Till date the team has successfully treated 6 such complex cases. The cases range from separating extra torso to separation of conjoined twins.
Conjoined twins are a rare event, occurring once in 100,000 births. Their survival rate is very low, about half of them may die before birth and another 25% soon thereafter. Only 25% survive in infancy. Conjoined twins arise from a single embryo. Hence they are identical and of the same sex. However, unlike normal twin, there is a failure of separation in fetal life and the pair of them is joined at some part of their bodies. Internal organs in this area of joining are also shared between the two.
James and John were referred to Narayana Health for evaluation and separation. All aspects of their anatomy were detailed, discussed and a well chart out plan was made for the separation operation. Fortunately for the babies, barring liver, all other organs such as intestines and biliary tree were separate. The liver was carefully divided along anatomical planes and the twins were separated. The babies required use of a mesh to ensure closure of their abdomen and that was also done successfully. Post operation, they have not only made a rapid and unremarkable recovery but also are in a position to live independent lives.
According to Dr. Ashley D’Cruz, Director & Senior Consultant Pediatric Surgeon & Urologist, separation of conjoined twins calls for a very detailed and complex intervention. First and foremost, the medications had to be calculated and distributed to both babies in a manner that both received optimal doses. Further, sedation and anesthesia had to be provided to both the babies. This is specifically challenging in this case as they are lying on their sides and cannot be put flat on their backs. Also, due to potential for cross circulation, careful administration of drugs had to be ensured.
“Successful separation is often very tough, but in James and John’s case, through careful planning and coordination between the various teams-medical, nursing, administrative, international liaison helped in the successful separation of the babies,” said Dr. Sanjay Rao, Senior Consultant, HOD of Pediatric Surgery and Senior Consultant, Division of Organ Transplantation, Narayana Health.
Narayana health city, conjoined twins, from nigeria
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