'Fiddly' surgery a huge success

18 November,2009 08:17 AM IST |   |  Khalid A-H Ansari

Surgeons in Australia separate conjoined Bangladeshi twins


Surgeons in Australia separate conjoined Bangladeshi twins

As people the world over anxiously awaited the outcome and the Pope lead an international prayer vigil at the Vatican, ground-breaking surgery continued at Melbourne's Royal Children's Hospital for the second day yesterday morning to separate Bangladeshi twins Trishna and Krishna, who were conjoined at the head.

After 27 hours of an arduous and intricate procedure, the first in Australia, which the surgery team described as "very fiddly", the surgery was declared a "huge success". However, doctors warned that the twins still have a long way to go before it can be ascertained that their motor skills are now normal.

Australian television channels telecast regular bulletins and politicians, not wanting to miss out, sent messages of good wishes even as nuns in Dhaka, where the twins were placed by their mother, organised a day of prayer.

Before the surgery, in Melbourne, the twin's legal guardian Moira Kelly gave them an emotional goodbye kiss and attended church yesterday along with surgeons who battled to save their lives. Their joint guardian Atom Rahman, who found them in the orphanage 2 u00bd years ago, also waited nervously.

Rahman, from the Children's First Foundation charity in Bangladesh, was overjoyed after arriving in Australia last Friday to see how healthy the twins were. Krishna and Trishna were close to death when they arrived in Australia two years ago, but survived after undergoing a series of preparatory operations.

"It is absolutely incredible. In Bangladesh, I would have only given them another week or two to live," he said. "Every day for them is a bonus".

After being sedated overnight, Krishna and Trishna were wheeled into surgery at 8.30 am (3 am IST on Monday), where neurosurgeons Wirginia Maixner and Alison Wray took over, cutting into the skull and separating blood vessels and the brain matter that still linked the twins, while retaining enough of the bony bridge to keep the area stable.

Smiling Angels: The next 48 hours are crucial for Trishna and Krishna.


A team of 16 neurosurgeons, plastic surgeons, and other medical staff were involved in the groundbreaking procedure, the first in Australia.

25% chance


The Bangladeshi orphans were given just a 25 per cent chance of making it through the operation without harm.
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The hospital's experts considered some level of brain damage a 50 per cent chance, and death was also a significant possibility.

However, surgeons were quietly confident, saying all the signs so far had been positive. "Everyone was particularly optimistic and excited," said plastic surgeon Tony Holmes.

Earlier operations to separate blood vessels shared by the twins had been a success with no new major connections appearing.

"If the blood vessels started to reconnect we would end up with pressure problems, but those connections didn't seem to be major," said Holmes.

After the neurosurgeons finished, the plastic surgeons returned, closing the brain lining and skulls with artificial caps, then closing the skin.

'Historic'

The twins were said to be "in great shape" and the operation, although not the longest in Australia, was described as "historic" and a "once in a lifetime" event.
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The tots will be sent to intensive care to minimise any emotional shock of being apart once they wake up.

"They will be nursed in as close an environment as possible because we recognise there is a significant trauma that is going to occur... they will be kept as close as physically possible," he said.

Brain scans over the next 36 hours will indicate when to make an attempt to wake them from their induced coma. But it could be weeks before it is clear whether the surgery has been a complete success.

(Source: The Age with AAP)

(This article was written for publication yesterday. It was delayed in transmission and has been updated for publication today.)

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Trishna Krishna conjoined Bangladeshi twins Surgeons