12-hour life-or-death operation a success as Israeli doctors separate conjoined twins

Following the operation, the twin sisters were able to see each other for the first time in their lives. 

By Donna Rachel Edmunds, World Israel News

In a first-of-its-kind operation for Israel, doctors have successfully separated twins conjoined at the head, allowing the girls to see each other for the first time in their lives.

“When the nurses brought the babies together, newly separated, they looked at each other, made noises, and gently touched each other — it was beautiful,” Dr. Isaac Lazar, director of the Pediatric Intensive Care Unit at Soroka University Medical Center in Beersheba, told the Times of Israel. “You could see the communication between them, and it was just so special.”

The girls were born just over a year ago, attached at the back of the head and facing away from each other. As the place where they were joined contained no skin or bone, doctors have been preparing the young sisters for the 12 hour life-or-death operation for some months now.

https://twitter.com/igal_malka/status/1434468912180178945?s=20

“It was complicated beyond anything one could imagine,” said Lazar. “We had to take action to make them grow more skin.”

Conjoined twins are rare and no two sets are alike, so the medical team had no example to follow. However, it was decided that the best way to proceed would be to insert inflatable silicone bags in the girls’ heads, between the skin and skull, and to fill them slowly.

“Every few days, sterile water was injected into the bags, increasing their volume,” Dr. Lazar said. “This stretched the skin slowly. After five to six months, these water-filled bags and the skin covering them became as big as the babies’ heads, and it looked like each baby had two heads.”

During this period, the medical team prepared for the big day – the separation surgery – using state of the art Israeli technology to create 3D models to practice their technique on.

“It was so delicate, as the surgery was performed between major blood vessels in the babies’ heads. We all knew that any bleed could have catastrophic consequences,” said Dr. Lazar.

Not only was the surgery complex, the Times of Israel reported, but every step along the way was too. Even hospitalizing the twins was difficult as intensive care facilities are designed to be used for one patient at a time; in the twins’ case, everything had to be doubled up.

But the hundreds of hours of preparation and intensive planning paid off. The separation took place during an intense 12-hour operation, with the medical team then dividing to work on the girls separately, reconstructing the missing part of the skull and closing the skin.

“After the operation the twins were moved to the ICU, ventilated and sedated. The next day they started breathing on their own and today [Sunday] they met each other for the first time, which was simply amazing.”

Until now the girls have not been able to move their heads, resulting in a physical handicap for both sisters. But Dr. Lazar explained that the decision to separate them at this young age was taken to give them the best possible chance to overcome their developmental delay.

“With the right rehabilitation for their physical and cognitive development, we expect them to catch up with their milestones … to allow normal development,” he said, adding, “our hope is that this is now very likely.”