Special team to decide on separation of conjoined twins

The conjoined twins born at a hospital here this week, have posed a medical challenge for doctors, and a special committee of four senior practitioners will take a call tomorrow on the surgery to separate them.
The twins, who have "a very complex internal architecture" were born at Sion Hospital here last Wednesday. Doctors at the hospital said the mother and the twins are in good health.
Shahin Khan (26) gave birth to the twins, who have fully developed heads, are joined from above the chest. They have three arms, with the third one protruding from the back.
The twins were diagnosed in an ultrasonography test conducted at the hospital during the woman's 32nd week of pregnancy.

Internally, the twins have one liver and a heart with two aortas. The right one has two lungs and the left one has one underdeveloped lung. The structure of urinary bladder is not clear.
The most intractable issue the doctors are facing is the ambiguity in the co-relation between the brain nerves and organs.

The conjoined twins are now under the care of paediatric surgeon Paras Kothari, who is examining if they can be separated without risking their lives.
"Conjoined twins (dicephalic paraphagus) are rare and difficult to carry an operation on. We are performing a few tests on them. Some have already been performed. As per results, we will proceed for the procedures of separation," Dr Kothari said.

"These twins are not the usual type. They have a very complex internal architecture. Externally they have two separate heads and necks, but a partially common thorax and are completely fused below the umbilicus level," he said.
To evaluate this complex operation, a few tests were conducted on multi-slice CT scanner, 3D rotational CT angiography, Dr Kothari said.
All these are multi-planar tests are used for reconstruction along with other complex CT techniques to diagnose the complex internal architecture of such babies.
A special committee consisting of four senior medical practitioners will take a call on their separation surgery tomorrow, he said.

"A few test reports are establishing the communication between the brains and other parts of the nervous system, including nerve supply to limbs, etc. 2D echocardiography is planned to evaluate the single heart. The babies will require many more investigations," hospital Dean Dr Suleman Merchant said.