Two girls joined at the head from birth (conjoined twins) recently survived 22 hours of surgery aimed at fully separating them. The surgery was performed in the All India Institute of Medical Sciences in New Delhi. The twins, Jagannath and Balram, aged 27 months survived this crucial phase of the operation which involved restructuring shared blood flow to the heart. The twins share a common vein that carries blood from the brain to the heart.
The girls have what is commonly known as ‘craniopagus twins’ – which is very rare, occurring once in 2.5 million births. Conjoined twins are genetically identical, and are always the same sex. Apart from fusion of the brain, other organs may be informed. The most popular set of conjoined twins Eng and Chang, who were known as Siamese twins. Interestingly, despite being joined at the lower chest, they went on to lead normal lives, getting married, having up to a dozen children and living till 1874 when they died at the age 63 years.
Most ‘craniopagus twins’ do not survive the first two years of life. In severe cases, they share brains or other body organs. Globally, only about 50 twins joined at the head have had surgery and few eventually survived. This surgery was what launched Dr Ben Carson into fame 30 years ago. The pediatric neurosurgeon led a team of doctors to operate on the Binder twins at 7 months. In contrast, in 1997, a surgery of Zambian twins left both patients alive and normal. Recently, Abby and Erin, 10 month old conjoined twins were operated successfully at Children’s Hospital, Philadelphia. The operation lasted 11 hours.
Unfortunately, separation often leaves one of the twins developmentally impaired or dead. In Dr Ben Carson’s first surgical operation on ‘craniopagus twins’, one of them later died and the other had brain damage required constant care and supervision.
The doctors acknowledged the possibly grim outcome when they said that ‘We are hoping to save both but even if one of the twins survives, it will be a historic achievement.’ “The kids will require one or two more operations within three months for final separation,” a member of the medical team informed. “The boys will be kept under observation till then.”
Because of the difficult nature of the surgery, the team of 40 doctors spent 2 months conducting tests, researching, consulting with experienced doctors that have performed similar surgeries. This has paid off thus far.
In the next few months, at least three more operations would be needed before the girls are finally separated.
Many individuals around the word are closely following this story while wishing the girls, Jagannath and Balram, all the best.