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Indian hospital separates African twins joined at abdomen and chest

Medical doctors at Apollo Children’s Hospital, Chennai, India, have successfully separated eight-and-a-half months old Thoraco Omphalopagus (the fusing of two bodies at the lower chest and abdomen) twins, Abriana and Adriana.

The babies who hail from Dar-es-Salaam in Tanzania, and joined at the chest and abdomen,sharing a single heart cavity and a liver are now, the first survivors of this type of separation in India.

In a live webcast, Plastic and Reconstructive Surgeon from Apollo Hospital, Dr K S Sivakumar, said the 11-hour long operation was conducted by a team of 50 staff members, including surgeons, nurses and intensive care specialists.

“This rare procedure involved separation of the pericardium (heart lining), diaphragm and the connected livers. Since 2007, eight pairs of conjoined twins with fused livers and intestines have been reported after separation from various parts of India”, he added.

Apollo-HospitalsAbriana and Adriana were conjoined and had been sharing a common heart lining and diaphragm. They also had a connected liver that had to be separated with minimal blood loss.

Chairman-founder, Apollo Hospitals Enterprises Ltd, Dr Prathap C. Reddy, said after being admitted in August this year, the twins, children of Jimmy Mtemi and Carol-yn Zakaria of Dar-es-Salaam, underwent the final separation surgery on November 11, 2014.

“It took seven hours for the surgery and another four hours for closure by plastic surgeons,” Dr Venkata Sripathi, who supervised the surgery, stated.

The surgery involved separation of the pericardium (heart lining), diaphragm and the connected livers. Conjoined births are rare, one in 50,000 to one in 1 lakh. However, more than 35 per cent die after birth.

Adriana had developed complications post-surgery and another procedure was carried out details of which were constantly shared on WhatsApp.

“Adriana’s heart had to be covered with bovine pericardium and carefully closed with skin and soft tissue. The liver, abnormally enlarged, could not be fully reduced in both babies,” said Dr K.S. Sivakumar admitted.

“In our over 30 years, Apollo Hospitals has always been a pioneer in healthcare delivery and has continued to excel with world-class clinical outcomes. We have once again demonstrated our prowess as a global destination for affordable yet world class healthcare.

Conjoined twins, though rarely encountered, are seen in one in 200,000 deliveries. However, more than 60 percent of them are stillborn while 35 percent of the remaining dies within a few days or months of birth due to various causes. Conjoined twins can be joined at the chest, abdomen, back, buttock and head.

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