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Thoraco Omphalopagus conjoined female twins from Tanzania were successfully separated at Apollo Children's Hospital

Date: 16 Dec 2014

In yet another medical marvel showcasing clinical excellence at Apollo Hospitals, doctors successfully separated the rare Thoraco Omphalopagus twins who were joined at the lower chest and abdomen. Technical and medical expertise helped prevent excessive blood loss during the separation, which was one of the most crucial aspects of the surgery along with precise division of the shared structures. Same time last year, Ericana & Eluidi, also from Tanzania, were the first pair of Pygopagus male twins to be successfully separated in India by Apollo Hospitals, thereby strengthening India's image as a preferred destination for world class healthcare delivery.

Hailing from Dar-es-Salaam, Tanzanian, twins Abriana and Adriana who are eight and a half months, were operated for 11 hours by a team of 50 staff members including surgeons, nurses and intensive care specialists. Father Mr. Jimmy Mtemi and mother Mrs. Carolyn Zakaria were visibly elated post the procedure.

On 21st August 2014, twins Abriana and Adriana were admitted under plastic surgeon Dr KS Sivakumar and on 10th September, they underwent a tissue expander surgery for extending the skin. The final surgery took place on 17th November where the twins were successfully separated by a team of 11 surgeons and 3 anesthetists after a surgery that lasted for 9 hours. It took 4 hours for two teams to then provide the skin cover for the heart, liver and intestine.

The team of doctors who undertook this case include under the supervision of Dr Sripathi include:

  • Radiologists: Dr Harish and Dr Rochita Ramanan
  • Anesthesia team: Dr Anuradha Vasudevan, Dr Vasantharoopan, Dr Rajagopal and Dr Sanjay Prabhu
  • Liver and gastrointestinal team: Dr Mahesh Gopasetty, Dr Anand Ramamurthy, Dr Anand Khakkar, Dr RK Bagdi and Dr Prakash Agarwal
  • Cardiac team: Dr Neville Solomon and Dr Ganapathy Subramanian
  • Plastic surgery team: Dr KS Sivakumar, Dr Ganapathy Krishnan, Dr Roshini Gopinathan and Dr Praveen Leela Kumar
  • Pediatric intensive care: Dr Suchitra Ranjit, Dr Indira Jayakumar and Dr Sathishkumar
  • Pediatric physician: Dr Jayakumar Reddy

Since 2007, eight pairs of conjoined twins with fused livers and intestines have been reported after separation from various parts of India.

Adriana and Abriana beat incredible 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 fifty thousand to one in a lakh. However more than 35% 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" added Dr. K S Sivakumar Plastic & Reconstructive Surgeon, Apollo Children's Hospital, Chennai under whom the twins were admitted.

Commenting on the feat Dr Prathap C Reddy, Chairman & Founder, Apollo Hospitals Enterprises Ltd. added "When I look back at 2014, I can only see how many lives we have touched in a positive way. More than the children's plight, it's often the trauma the parents go through that haunts me. With many developing nations like Africa lacking in tertiary care, we often find them coming to India as we have the expertise and skill to offer world class healthcare at a fraction of a cost. It's heartening to know this Christmas eve Jimmy and Carolyn can be back home with their two daughters and the rest of their family".

Before separation

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After separation

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