Re­lief, joy as twins start new life apart

The Advertiser - - NEWS - GRANT MCARTHUR

WHEN sur­geons fi­nally got the an­swer to the ques­tion they have long asked – and feared – a sense of re­lief swept over Royal Chil­dren’s Hos­pi­tal’s The­atre 6.

Since first set­ting eyes on a set of rudi­men­tary scans from Bhutan, Mel­bourne’s Royal Chil­dren’s spe­cial­ists won­dered ex­actly what was go­ing on in­side Nima and Dawa Pelden’s con­joined bod­ies.

Af­ter a year-long ef­fort to save the 15-month-old sis­ters, the mas­sive team got the per- fect an­swer. “Our great­est chal­lenge, we al­ways knew, was: ‘What are we go­ing to find when we first went into the ab­domen?’,” head of pae­di­atric surgery Dr Joe Crameri said.

“Once we re­alised that we had the abil­ity to di­vide the liver with­out com­pro­mis­ing the girls and ul­ti­mately that we did not have to do any­thing fancy with the bowel. That was cer­tainly a sense of re­lief for us.

“All the hard work and ef­forts over the past weeks re­ally paid div­i­dends (yes­ter­day).

“We saw two young girls who were very ready for this surgery, who were able to cope with the surgery, and are re­cov­er­ing and do­ing very well.

“I see it as a sense of re­lief, we al­ways felt con­fi­dent we could achieve this.”

From the mo­ment yes­ter­day’s process be­gan, Nima and Dawa be­gan act­ing like in­de­pen­dent girls with one suc­cumb­ing to anaes­thetic quickly, while the other took more than two hours.

When surgery did be­gin the team – which swelled to 25 dur­ing some sec­tions of the six-hour op­er­a­tion – were over­joyed to find there was no sig­nif­i­cant bowel at­tach­ment re­quir­ing ex­ten­sive surgery but rather just over­lap­ping or tan­gle or­gans.

As Dr Tom Clar­nette then led ef­forts to sep­a­rate the twins’ shared liver he found some is­sues were a lit­tle more sig­nif­i­cant that they ex­pected – but more re­lief when both had the nec­es­sary “plumb­ing” and there were no bleed­ing dif­fi­cul­ties.

“We were never cer­tain of ex­actly what we were go­ing to find but we were pleas­antly sur­prised we didn’t get any un­ex­pected curve balls,” he said.

Then, just be­fore 12.45pm yes­ter­day, the girls were of­fi­cially sep­a­rated and sta­ble.

The cru­cial ef­fort to re­con­struct the girls’ now in­di­vid­ual bod­ies saw the the­atre and surgery team split in two with sur­geons Dr Crameri and Dr Liz McLeod tak­ing care of Nima as Dr Clar­nette and Dr Michael Nightin­gale re­built Dawa.

Re­con­struc­tion of the ab­domen was thought to be the day’s big­gest chal­lenge, how­ever both girls had enough mus­cle and skin to close over the gap in their chest.

Although it was hoped the girls could avoid the need to re­cover in in­ten­sive care, the de­ci­sion was made about 5pm to move them into the high­needs area, though they con­tinue to re­cover very well and are ex­pected to be in hos­pi­tal for about a week.

“It is a re­lief and it is also joy. There is noth­ing bet­ter with any op­er­a­tion that to be able to go to the par­ents and say ‘we have been able to look af­ter your child, we have been to do what we set out to do and are con­fi­dent they will re­cover from this and go for­ward’,” Dr Crameri said.

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