Conjoined Twins Are Successfully Separated Using Complex Procedure

Jul 23, 2020 by apost team

Last month, conjoined twins, Ervina and Prefina Bangalo, from Mbaiki, Central African Republic were separated. The procedure involving more than 30 doctors and nurses was done at the Bambino Gesu Pediatric Hospital.

The occurrence of conjoined twins is rare. Besides, there is always a high risk of attempting to separate them. However, this was not the case for the 2-year-old twins. The twins were born on June 29, 2018, and were attached at the head. They shared some critical blood vessels around the brain, reports Deutsche Welle.

These blood vessels made the operation riskier and more invasive. Since it’s a rare procedure to detach conjoined twins, doctors seldomly attempt it. The goal of the surgery was to separate the girls while keeping them as healthy as possible. The team that led the operation had prepared for nearly two years.

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Cases of conjoined twins happen once in 49.000 to 189.000 births, depending on which region of the world you live in. Previously, there have been successful separation surgeries. However, most of the operations involved twins that were fused vertically. The skulls of Ervina and Prefina were joined back to back.

This type of fusion is known as a total posterior craniopagus. The fusion made the surgery challenging since the back of the head hosts some of the major blood vessels. Disrupting the flow of blood to the brain can cause debilitating injuries and brain damage.

When conducting the surgery, the doctors were not sure whether it was safe. In the vertical separations, surgeons can borrow blood vessels to share between each twin. However, this is not the case for a total posterior craniopagus. There is no room for borrowing veins when it comes to the back of the head.

The most complicated part of the surgery was giving each child independent venous systems. The procedure was done in May and June of 2019 with two surgeries, as the Italian hospital reports. The final operation last month was to finally separate the twins physically after their internal structure had been changed and adapted to make it possible. 3-D imaging and neurostimulators were used during the operation.

Before the separation surgery, each of the twins was given mirrors to see one another. It is very important during complicated brain surgeries that the patient stays conscious, so that doctors immediately notice when something starts going wrong. Since the twins were still so young, the mirrors made sure they would be making noise and staying active.

The chief of pediatric neurosurgery at Bambino Gesu, Dr. Carlo Marras, noted that the process was not only professional but also humane. Despite the very realistic chance that it could fail, the doctors had pulled it off.

A similar surgery that was carried out in 1987 did not have such impressive results. The twins, born in Germany in 1987, suffered neurological problems following the surgery. One of them fell into a coma he never awoke from before finally dying in 2014, while the other suffered severe brain damage and developmental delays that make his hospitalisation even today necessary.

Ervina and Prefina’s mother, who never went to school, wishes that her daughters become doctors in the future. She wants them to save other children in the world. The mother was grateful to Dr. Carlo and Pope Francis, who visited the Central African Republic in 2015.

Pope Francis supported the collaboration between Bambino Gesu and a pediatric hospital in the Central African Republic. As NBC reports, Nzotto, the twins’ mother, wishes Pope Francis would baptize her two daughters.

Mariella Enoc, the hospital’s president, visited the Central African Republic soon after the twins were born. She became the driving force to bringing them to Rome. She had the belief that the twins could be separated.

During the process, she was faced with ethical and economic questions. The cost of the surgery was valued at 1 million euros (roughly 1.15 million dollars) and was paid by the hospital foundation. However, many believed that money could be used on less risky procedures. Enoc believed in saving life first.

The twins are now recovering and have a new chance to live. Scans have shown that their brains are intact, and the children will have healthy growth. If you liked this story of a medical near miracle, please make sure to pass it on to your friends and loved ones.