Head-joined twins undergo complicated separation surgery

It's not every day we hear about Siamese twins, let alone head-joined brothers. This is because, besides the birth of babies connected by some part of the body being rare - occurring once every 200, 000 births -, it is not always possible to separate the siblings and, when it is, surgeries usually involve risks and are complicated.

Because, according to The Washington Post's Lindsey Bever, skull-bound babies come into the world are even rarer - representing only 2% of all Siamese - and, as you can imagine, separation procedures are far more risky for babies and involve more difficulties. But a couple of little girls have just had a long surgery in the US, and at the moment it looks like they're both doing well.


According to Lindsey, the twins were born 10 months ago in North Carolina and doctors identified her condition early in her pregnancy when her mother was approximately 11 weeks pregnant. So the parents of the babies decided to seek help from a Pennsylvania hospital for prenatal care, and even without knowing if the little girls could be separated after birth, a medical team began planning the surgery.

(Ed Cunicelli / Children's Hospital of Philadelphia via AP)

The twins were born in July last year through a caesarean section and since then the hospital team has spent months conducting exams and studying the best way to separate girls. The problem with this type of surgery specifically is determining what structures the twins share, especially the blood vessels and veins related to drainage in the brain, since one child usually has a better condition than the other.

In addition, doctors need to consider the ethical issues involved in surgery, as children may not survive the procedure - or one may endure the intervention while the other ends up dying or living with severe neurological problems. Not to mention the challenges related to recovery and long-term prognosis.

High risk surgery

According to Lindsey, the surgery took place on June 6 and involved the participation of a team of 30 people - including surgeons, nurses and a support team. The procedure lasted 11 hours and first the doctors treated the twins as a single organism and then they split into two groups to operate the girls individually once the separation was completed.

The surgery was meticulously organized and all the equipment used was color coded, one for each patient. Doctors began the separation of blood vessels and the dura mater, the outermost and most resistant layer of meninges - the membrane system that surrounds and protects the brain - and the most complicated step was the separation of the sagittal sinus. Finally, the team split into two teams, and each team proceeded with the reconstructive part of the operation.

According to doctors, the twins will likely have to undergo other surgeries, but everyone is confident that the little girls will be discharged by the end of the year. The parents of the little babies, as you might imagine, are overweight and counting the days to finally bring them home.


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