Head-joined twins survive 22-hour first operation, more needed

After a marathon procedure on the conjoined twins of Kandhamal that lasted 22 hours, doctors at All India Institute of Medical Sciences (AIIMS) have completed the first step in separating Jaga and Baliya Kanhar.

After creating a new channel to carry venous blood using an innovative bypass technique, doctors managed to separate a significant portion of the boys' brain on Tuesday morning.

Surgery started at 9 am on Monday and went on till 6.30 am on Tuesday. A Japanese expert was present during the process, which was complicated by the 27-month-old boys sharing the vein that returns blood to the heart from the brain.

"Surgery was uneventful and there was no major blood loss or intra-operative problems," said Dr Deepak Gupta, the paediatric neurosurgeon who led the operation under the guidance of Dr Ashok Kumar Mahapatra, director of SGPGIMS of the neurosurgery department.

Dr Mahapatra said a team of around 20 specialists, including the surgeon from Japan, operated the twins. He said both the kids were doing relatively well after the surgery.

He said the twins are on ventilator and doctors are planning to bring them out of the ventilator on Wednesday. ''Though the twins are in life support system, they are opening their eyes and moving their hands and legs,'' he said.

In appearance, the twins remain joined at the head as earlier. "The kids will require one or two more operations within three months for final separation," a member of the medical team said. "The boys will be kept under observation till then."

Doctors said they are keeping their fingers crossed that the twins would recover well and be able to undergo another surgery so they can live normal lives.

Professor S S Kale, head of neurosurgery at AIIMS, disclosed that surgical planning had begun two months ago, and 40 doctors were involved at various stages of the planning of this extremely rare and complex process of separating twins joined at the head.

Globally, only about 50 twins joined at the head have been taken up for surgical separation and few of them have survived. In such cases, even if one of the twins survives to lead a normal life, it is considered a major achievement.

The parents of Jaga and Baliya, poor farmers from Odisha's Kandhamal district, had sought the help of the government to fund their surgical separation. "We are thankful to our state government for arranging the transportation and other costs involved," Bhuiyan Kanhar, the twins' father, told doctors.

Sources said Odisha chief minister Naveen Patnaik and health minister Pratap Jena are closely following the medical developments. Jena, who is coordinating with the AIIMS, said a surgeon from the US would be involved during the second phase surgery.

At least one other pair of twins joined at the head is surviving without surgery in India. Sisters Saba and Farah of Patna are 20 years old. They were not operated upon because of the risks involved.

Surgeons at Montefiore Hospital in New York recently separated 13-month-old twins joined at the head.