Saturday, 15 December, 2018

Surgeons in Australia separate conjoined girls from Bhutan

Conjoined twins to undergo life-changing separation surgery at Melbourne's Royal Children's Hospital Conjoined twins: Australian surgeons try to separate Bhutanese girls
Gustavo Carr | 10 November, 2018, 04:23

Nima and Dawa were born by caesarean section on July 13 a year ago in a regional hospital in the Himalayan Kingdom of Bhutan, shocking doctors and the twins' family who had been expecting twins, but did not know they were conjoined.

Funds for the girls' operation, which estimated to cost about $180,000 (250,000 AUD), according to 9 News, was raised by Children First Foundation, a Melbourne-based nonprofit. A nurse was by her side.

The pair were joined at the torso and shared a liver, but turned out not to share part of their bowel, as the doctors once believed.

Head of paediatric surgery Dr Joe Crameri, who led the operation, said there had been no surprises despite fears the girls' bowel were shared.

"The positioning makes it hard for surgeons Joe Crameri, Tom Clarnette and Michael Nightingale, who are charged with separating the gilrs' shared liver, crossed over bowels and any other internal organs", it states.

The girls were separated for the first time in a six-hour surgery at Melbourne's Royal Children's Hospital.

The worst-case scenario would have been if the girls shared a component that was vital to both. "But there is nothing on the image that suggests that", Dr Crameri said.

He said the major challenge had been to reconstruct the twins' abdomens.

A breakdown of the 18-strong medical team.

They headed into the theatre at 8am, and doctors planned to administer anaesthesia around 8.45am.

Twins Nima and Dawa at a previous visit to the hospital.

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Doctors successfully divided the twins' liver.

"Mom said the girls are getting a little bit frustrated with each other, as you would at 14 months", the charity's CEO Elizabeth Lodge said last month.

She spent Friday praying and meditating. She tends to ... always be on the top, pulling rank, as we say, and Dawa's more placid, ' she said.

"She still has this extraordinary calmness about her, which is just fantastic".

"We have been able to remove their breathing tubes so they are breathing independently and that was a very important step after the operation", Crameri said.

One of the biggest operating theatres was commandeered for the procedure, which involved two teams of anaesthetists - one for each sister.

Several members of the surgical team had worked on the operation to separate conjoined Bangladeshi twins Trishna and Krishna in 2009.

Dr Sherub first met the girls when they were only a day old and played a major role in getting the twins to Australia, having already spent time in the country as the victor of a medical scholarship.

They arrived in Australia last month and their surgery started Friday morning after doctors deemed them ready.

They were brought to Melbourne with their mother to have surgery in October, but it was postponed so the girls could improve their nutrition.