Conjoined twins separated after 11-hour rare surgery

Doctors at a city hospital here successfully separated rare Thoraco Omphalopagus twins who were joined at lower chest and abdomen in an 11 hour operation conducted by a team of 50 staff members.
Technical and medical expertise helped prevent excessive blood loss during the separation, which was one of the most crucial aspects of the surgery along with precise division of the shared structures.
Hailing from Dar-es-Salaam, Tanzanian twins Abriana and Adriana, all of eight-and-a-half month, were operated for 11 hours by a team of 50 staff members including surgeons, nurses and intensive care specialists, doctors said.
Father Jimmy Mtemi and mother Carolyn Zakaria were visibly elated post the procedure.

Adriana and Abriana beat incredible odds to survive this rare procedure, which involved separation of the pericardium (heart lining), diaphragm and the connected livers. Conjoined births are rare - one in 50000- to one in one lakh. However more than 35 per cent die after birth.
"Since 2007, eight pairs of conjoined twins with fused livers and intestines have been reported after separation from various parts of India.

"Aradhana and Stuthi were the only pair of twins with two hearts in one cavity -- a condition similar to the case of the Tanzanian twins. Though separation was successful, Aradhana died after three weeks reportedly after heart attacks," said Dr K S Sivakumar Plastic and Reconstructive Surgeon from Apollo hospital.

Same time last year, Ericana and Eluidi, also from Tanzania, were the first pair of Pygopagus male twins to be successfully separated in the same hospital.
Another important aspect of the surgery was the careful closure of the huge defect created by the separation.
"After the separation, Adriana's heart had to be covered with bovine pericardium and carefully closed with skin and soft tissue. The liver, which was abnormally large, could not be fully reduced in both babies. It took almost four hours and two teams to provide cover for the heart, liver and intestine," said Sivakumar.
Commenting on the feat, Dr Prathap C Reddy, Chairman and Founder, Apollo Hospitals Enterprises Ltd said, "With many developing nations like Africa lacking in tertiary care, we often find them coming to India as we have the expertise and skill to offer world class healthcare. It's heartening to know this Christmas eve Jimmy and Carolyn can be back home with their two daughters and the rest of their family.