The Daily Telegraph (Sydney) - - News - GRANT MCARTHUR

WHEN sur­geons fi­nally got the an­swer to the ques­tion they had 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, Royal Chil­dren’s spe­cial­ists had won­dered just 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 team got the per­fect an­swer yes­ter­day.

“Our great­est chal­lenge … was what are we go­ing to find when we first went into the ab­domen,” pae­di­atric surgery head Dr Joe Crameri said.

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

“All the hard work and ef­forts over the past weeks re­ally paid div­i­dends to­day. 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, the other tak­ing more than two hours.

When surgery fi­nally be­gan, the team — which swelled to 25 dur­ing some sec­tions of the six-hour op­er­a­tion — were over­joyed to find there was no sig­nif­i­cant bowel at­tach­ment but rather just over­lap­ping or tan­gled or­gans.

As Dr Tom Clar­nette then led ef­forts to sep­a­rate the twins’ shared liver, he found some is­sues were a lit­tle more sig­nif­i­cant than ex­pected but there was more re­lief to find both girls 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 curve balls,” he said.

Just be­fore 12.45pm, the girls were of­fi­cially sep­a­rated and sta­ble.

The med­i­cal team then also split in two for the cru­cial ef­fort to re­con­struct the girls’ bod­ies. The ab­domen was thought to be the big­gest chal­lenge but both girls had enough mus­cle and skin to close the gap.

“It is a re­lief and it is also a joy,” Dr Crameri said af­ter the surgery.

Nima and Dawa with mum be­fore surgery, the mo­ment they were sep­a­rated (inset top) and doc­tors cel­e­brate the suc­cess­ful op­er­a­tion.

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