3 risky surgeries to separate twins
CONJOINED twins whose skulls were fused back-to-back and who had “one of the rarest and most complex forms of cranial and cerebral fusion” doctors had seen, have been successfully separated.
The two-year-old sisters Ervina and Prefina, were born in 2018 in Mbaiki, Central African Republic, with their heads attached and sharing critical blood vessels around their brains.
However, surgeons at the Bambino Gesu Paediatric Hospital in Rome, which is Vatican-owned but operates within the Italian public health system, have now successfully separated them following three risky surgeries.
The hospital said it was the first time in Italy and likely the world that surgeons were able to separate twins with the rare congenital defect in such a way. The two sisters were brought to Italy in September 2018 after the hospital’s president met the twins and their mother at a medical centre where they were born.
Tests conducted in Italy showed the twins to be generally in good health but that one sister’s heart was working harder to maintain the “physiological balance of the organs of both, including the brain”.
The greatest challenge facing the team of specialists – including neurosurgeons, anaesthesiologists, neuroradiologists, plastic surgeons, engineers, and physiotherapists – was the shared network of blood vessels bringing blood from the girls’ brains to their hearts, the hospital said.
The procedure required “three very delicate operations to progressively reconstruct two independent venous systems”, it said.
The final surgery, which took 18 hours and involved 30 doctors and nurses, took place on June 5 when the bones of the shared skull were divided.
Surgeons reconstructed the membrane covering the two brains and recreated the skin lining over the new skulls.
“A month after the final separation, the twins are fine,” said the hospital.
Dr Carlo Marras, chief of paediatric neurosurgery, who led the team that worked for nearly two years planning and executing the separation, said the sisters would be able to lead a normal.
Before the separation surgery, members of the Vatican hospital’s staff gave the girls mirrors so they could see one another.
The twins’ mother, Ermine Nzotto, said: “It’s a joy, that I can see my girls run and play like other children.
“May they tomorrow study and learn to become doctors to save the other children of this world.”
She thanked Marras, the hospital president and Pope Francis, who visited CAR’s capital of Bangui in 2015 and has since strongly supported Bambino Gesu’s collaboration with the paediatric hospital there.