Doctors at All India Institute of Medical Sciences, Delhi, have separated conjoined twins who were joined from chest and upper part of the belly. The twins- Riddhi and Siddhi – were diagnosed as thoraco-omphalopagus conjoined twins prior to birth in the fourth month of pregnancy.
Dr Minu Bajpai, head of Department of Paediatric Surgery, AIIMS, said that the twins were born on July 7 last year and were in the ICU for five months and were separated on June 8 last month following a nine-hour long surgery. The twin girls celebrated their first birthday at the hospital. The surgery was performed under general anesthesia in the newly-commissioned Mother and Child Block at AIIMS.
“The anomaly was peculiar with fused rib cages, livers, partially common diaphragms and fused pericardium (outer covering of the heart). Both the hearts were very close to each other, almost touching and beating in contact. The pericardium was partially fused,” Dr Prabudh Goel, Additional Professor in the Department of Paediatric Surgery, said.
Dr Goel added that the girls were operated at the age of 11 months when they were old enough to tolerate the trauma of surgery. Prosthetic tissues and grafts were kept available for possible use, however, these were not required since the kids had enough of native tissues to complete the repair successfully, he stated.
“Steps in the surgery involved separation of the common abdominal and chest walls, division of liver tissue in a way that sufficient tissue remain for each baby, division of fused rib cage. It also involved separation of diaphragm, and of pericardium,” Dr Bajpai said.
Separation of the livers and the region of the heart was challenging, and multiple teams of surgeons took turns to complete the surgery precisely and efficiently. They are now ready to be discharged from the hospital, said the hospital.
The Paediatric Surgery department has successfully separated three pairs of conjoined twins over the last three years with the case of Riddhi and Siddhi being the latest. The first and second pair of twins were joined at the hip and shared a common spinal cord and major vessels of the lower body and legs. The first operation was done in 2020 and the second in 2021.
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