THE conjoined twin girls from Pongola are ‘recovering well’ after a 13-hour operation at Inkosi Albert Luthuli Central Hospital in Durban.
The separation took place on 11 March, and practice runs were done both a week before and a day before the operation to ensure correct and meticulous set-up in theatre.
Dr Harshavan Mackanjee, Chief Specialist of Paediatric Medicine, said that on the day the babies were incubated, ventilated and anaesthetised before their single thoracic cavity was opened.
‘We were happy and relieved to find that the hearts were separated, which meant that the twins did not require cardio-pulmonary bypass.
‘Their livers needed separation, among other organs,’ he told Bay Watch.
Positive signs
On Friday morning, one of the twins was weaned off from the ventilator support and is currently breathing on her own.
Her sister on the other hand was still on ventilator and showed signs of missing her twin, and was given a mirror on her cot to create an impression that the other was still around.
Both are expected to be out of intensive care within the next 4 weeks.
Zululands own
In October last year the ZO reported that a 31-year old mother from Pongola had given birth to conjoined twins in a delivery that was conducted by family members at her home.
When the baby girls were found to be conjoined, they were taken to Itshelejuba Hospital before being transferred to Lower Umfolozi War Memorial Hospital (LUWMH) in Empangeni.
It was here that they were assessed and found to be joined at the chest and abdomen and immediately transferred to the Neonatal Intensive Care Unit (NICU) at Inkosi Albert Luthuli Central Hospital for further management.
In this first class facility they were subjected to various investigations that included X-rays; cardiac echocardiograms; CT scans and CT angiograms.
It was found that they shared a common pericardial sac with a possibility of a shared myocardium and that they also had fused livers.
One positive finding was that their gastro-intestinal tracts were completely separate, which made it possible to feed them independently.
A decision was made after discussions with the paediatric surgical team and the cardiology team to continue conservative management until the twins attained a combined weight of approximately 10 kg – before any operation was considered.
They have since been kept at the Neonatal Intensive Care Unit.
‘All along the parents were given continuous support and counselling by the team of doctors, nurses and social workers,’ said Dr Mackanjee.
At five months of age they were assessed and found to have attained a combined weight of 9.7kg and then given further evaluations regarding cardiovascular and hepatic systems.
Plastic surgery consultants also evaluated the necessary procedures required to obtain closure of the chests and abdomens after separation. Consultations here also involved Cardiothoracic Surgeons and Anaesthesiologists.’
The operation was then completed by the Plastic Surgical Team who used various techniques to ensure closure of the thorax in both the twins.
Meanwhile KwaZulu-Natal Health MEC Dr Sibongiseni Dhlomo expressed his sentiment following the successful surgery.
‘Our gratitude again go to all the Specialists teams who amassed all their experience; acumen and expertise to successfully carry out this delicate; life threatening and precarious ground breaking operation.
‘Indeed, it is only in a public health care institution that such a team of Specialists can be mobilised and assembled to perform a surgical operation of this nature at no cost to the patient,’ said MEC Dhlomo.
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