Con­joined twins flown from Bhutan to Aus­tralia for sep­a­ra­tion op­er­a­tion

Bhutan Times - - Editorial -

(CNN) A pair of con­joined twins have been flown from Bhutan to Aus­tralia, where doc­tors hope they will be able to op­er­ate on the 14-month-old girls, who have grown up fac­ing each other, un­able to move in­de­pen­dently.

Joe Crameri, a doc­tor at Mel­bourne Royal Chil­dren’s Hos­pi­tal, said staff were ex­am­in­ing the twins, Dawa and Nima Pelden, who are joined at the stom­ach, with the hopes they will be able to carry out of a lifechang­ing op­er­a­tion to sep­a­rate them.

“Once we’ve got that in­for­ma­tion, then we’ll be able to for­mu­late a more cor­rect plan for how we can sep­a­rate these twins but at the mo­ment we re­main con­fi­dent that we should achieve that in a sin­gle op­er­a­tion and we should be able to achieve a good out­come for both twins,” Crameri said.

A team of six sur­geons and dozens of spe­cial­ist nurses have been as­sem­bled for what is likely to be a lengthy op­er­a­tion on the twins, ac­cord­ing to CNN af­fil­i­ate 9 News.

“All these twins are unique in the way that they’re con­nected. This set of twins are con­nected pre­dom­i­nantly in the ab­domen, maybe slightly in the lower part of the chest,” Crameri said.

“We know the key ar­eas that we’re go­ing to have to fo­cus on are the bowel and the liver. We’re hop­ing that we don’t have to deal with any of the struc­tures in their chests and the ini­tial re­port sug­gests that we won’t have to.” ‘They’re get­ting cranky’ Funds for the girls’ op­er­a­tion was raised by Chil­dren First Foun­da­tion, a Mel­bourne-based non profit, and is es­ti­mated to cost around $180,000 (250,000 AUD), ac­cord­ing to 9 News.

“Mom said the girls are get­ting a lit­tle bit frus­trated with each other as you would at 14 months,” the char­ity’s CEO El­iz­a­beth Lodge said Tues­day.

“Like any sib­lings they’re get­ting cranky so mom’s re­ally look­ing for­ward to the op­er­a­tion hap­pen­ing sooner rather than later.”

Born via a cae­sarean sec­tion last year, the girls are be­lieved to be Bhutan’s first con­joined twins.

As well as the is­sues with mo­bil­ity and com­fort, Lodge said the twins had re­cently been los­ing weight, which had been a con­cern to doc­tors who are now ob­serv­ing them closely.

Sev­eral mem­bers of the sur­gi­cal team which will work to sep­a­rate the Bhutanese girls pre­vi­ously worked on the suc­cess­ful op­er­a­tion to sep­a­rate con­joined Bangladeshi twins Tr­ishna and Kr­ishna in 2009.

They were sep­a­rated af­ter a marathon 27-hour surgery, despite doc­tors ini­tially giv­ing them only a 25% chance of mak­ing it. Dif­fi­cult surgery Con­joined twins oc­cur once ev­ery 200,000 live births, ac­cord­ing to the Univer­sity of Mary­land Med­i­cal Cen­ter. About 70% are fe­male, and they are al­ways iden­ti­cal twins.

Sci­en­tists be­lieve that con­joined twins de­velop from a sin­gle fer­til­ized egg that fails to sep­a­rate com­pletely as it di­vides.

“Although two fe­tuses will de­velop from this em­bryo, they will re­main phys­i­cally con­nected — most of­ten at the chest, ab­domen or pelvis. Con­joined twins may also share one or more in­ter­nal or­gans,” ac­cord­ing to the Mayo Clinic.

“The suc­cess of surgery de­pends on where the twins are joined and how many and which or­gans are shared, as well as the ex­pe­ri­ence and skill of the sur­gi­cal team.”

They were pre­vi­ously com­monly re­ferred to as “Si­amese twins,” a name which orig­i­nated with Eng and Chang Bunker, a set of con­joined twins who were born in Siam (now Thai­land) in 1811. They lived to age 63 and ap­peared in trav­el­ing ex­hi­bi­tions. Chang and Eng both mar­ried and fa­thered a to­tal of 21 chil­dren be­tween them.

While sep­a­ra­tion surg­eries of twins joined at the ab­domen and other parts of their bod­ies, twins joined at the head are at a far greater risk.

The case of two US boys joined at the top of their skulls at­tracted global at­ten­tion in 2016 as doc­tors suc­cess­fully op­er­ated to sep­a­rate them.

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