The Nigerian twins had much in common apart from similar faces. Joined at the sacral regions and hips, they had fused spinal cords and nerve routes and shared a common passage for faecal matters and passing urine.
Their parents were told back home at Kano in Nigeria that one of the girls would stand to lose her life if a separation surgery was carried out. Since the two children were hale and hearty, it was not a decision Badariyya Badaru, the mother, could make.
As a last resort, the parents decided to bring the two children, Hussaina and Hassana, to Delhi, a popular medical tourism destination for Nigerians.
“It was a big challenge as the Badaru twins had unusual sharing of alimentary canal, genitourinary system and nervous system,” said Dr Prashant Jain, pediatric surgeon at BLK Hospital, where the girls were successfully separated on August 12 this year.
Fusion of their spinal cords and nerve routes made the surgeries more complicated. “It was a bunch of nerves, making it very difficult to detect which belonged to whom. Even a minor error could have been fatal,” said Dr Praveen Khilnani, head of paediatric critical care. This rare fusion also made it only the fourth such case recorded globally so far.
Challenging job
But the most difficult job was the anaesthetist’s, who was challenged by the presence of a large sharing vein.
“Whatever drug was given to one twin, the other would receive it inadvertently through the large sharing vein. It needed to be calculated and monitored carefully,” said Dr U K Valecha, head of anaesthesiology.
To deal with the numerous challenges that the surgeries posed, doctors carried out rehearsals on dummies. Apart from the girls, even the tubes, wires, catheters, leads, syringes, injections and drugs were colour coded to avoid errors.
Staff donate blood
The main surgery lasted for about 13 hours, after which there was reconstructive surgery for another five hours. “The hospital’s own staff, including the medical superintendent, donated blood to the children,” said Dr Praneet Kumar, CEO of the hospital.
Plastic surgeons at the hospital constructed a new genitourinary tract with new genitalia for each of the children. Their intestines were also repaired with separate anal openings.
“The siblings are now stable and capable of leading totally separate and normal lives,” said Dr Praneet. They are expected to return to Nigeria in a day or two.