Tanzanian conjoined twins surgically separated

In a rare surgery, a team of doctors at a private hospital here successfully separated Tanzania’s eight and a half month old twins—Abriana and Adriana—who were joined at their chest and abdomen.

The twins who shared a single heart cavity and a connected liver are the only living thoraco-omphalopagus conjoined twins who have undergone successful separation in India.

Technical and medical expertise helped prevent excessive blood loss during the separation, which was one of the most crucial aspects of the surgery performed at the Apollo Hospitals here, along with precise division of the shared structures.

Abriana and Adriana were operated for 11 hours by a team of 50 staff members, including surgeons, nurses and intensive care specialists.

The twins from Dar es Salaam beat all odds to survive this rare procedure, which involved separation of the pericardium (heart lining), diaphragm and the connected livers. Conjoined births are rare – one in 50,000 to one in one lakh. However, more than 35 per cent die after birth. Another important aspect of the surgery was the careful closure of the huge defect created by the separation. 

“After the separation, Adriana’s heart had to be covered with bovine pericardium and carefully closed with skin and soft tissue. The liver, which was abnormally large, could not be fully reduced in both babies. It took almost four hours and two teams to provide cover for the heart, liver and intestine” said Dr K S Sivakumar, Plastic & Reconstructive Surgeon.

The twins were admitted recently and underwent tissue expansion surgery. A team of 11 surgeons and three anesthetists separated the twins after a nine-hour procedure, Sivakumar said.