Sisters sharing liver successfully separated

Two-month-old conjoined twins sharing a liver successfully underwent surgery at a hospital here to separate them.

Saboora and Safoora were born with "Omphalopagus", a disorder in which twins are born joined at the abdomen and share a liver. Such cases are the rarest of the rare and occur one in 100,000 births, with three out of four cases being girls.

After several clinical checkups, the sisters were brought to Medanta Medictity, where they were operated Nov 16 by a team of 40 doctors led by liver surgeon A.S. Soin.

Medical experts said the case was also different from others as there was no described anatomy of a liver that is shared between two humans, and no standard technique to split it.

They said that the separation of the common organ between the twins was fraught with the risk of bleeding and the danger of landing up with an inadequately functioning liver in one or even both babies.

However the twin sisters before undergoing hours long surgery had to undergo four different body scans - a triphasic CT scan, a nuclear isotope hepatobiliary scan, a high resolution chest CT scan and also separate dye study of their intestines.

The twins were later on separated successfully.

"This was one the most challenging surgeries of my career. As even a minute error would have left things much worse," said Soin, Liver Institute Chairman and the Chief Liver Surgeon at Medanta medicity.

"Apart from the liver, it was important to rule out possible communications of the two hearts and their coverings, the covering of the lung, and the intestines as that would have changed the surgeons plan completely."

"While the occurrence of the twins was rare, the chances that two twin girls sharing a common liver would be successfully separated were one in about 50 million. We are glad that every thing went successfully," he added.

Neelam Mohan, Director of Pediatric Gastroenterology, Hepatology and Liver Transplant, said: "After the separation was done, the ICU management was difficult as their bodies took time to adjust to the sudden cessation of the shared circulation and metabolism."