Materiały źródłowe

• #1 Conjoined twins – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conjoined-twins/diagnosis-treatment/drc-20353915

  Conjoined twins can be diagnosed using routine ultrasound as early as 7 to 12 weeks of pregnancy. […] Treatment of conjoined twins depends on their unique situation their health issues, where they’re joined, whether they share organs or other vital structures, and other possible complications. […] If you’re carrying conjoined twins, you’ll likely be closely monitored throughout your pregnancy. […] Your specialists and others on your health care team learn as much as possible about your twins. […] After your conjoined twins are born, they’re fully evaluated. […] If a decision is made to separate the twins, separation surgery is usually done around 6 to 12 months after birth to allow time for planning and preparation. […] Many complex factors must be considered as part of the decision to do separation surgery.

• #1 Conjoined Twins | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/conjoined-twins

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. […] A thorough prenatal evaluation is particularly important for conjoined twins, as the location and extent of where the twins are joined and what organs are shared play a crucial role in deciding whether the twins will be separable. […] Expectant mothers visiting the Center for Fetal Diagnosis and Treatment at CHOP will undergo a full day of advanced imaging. This helps us to collect a detailed picture of the shared organs and any associated problems. Prenatal diagnosis will help identify the optimal treatment and delivery plan, and the potential for separation after birth. […] If the conjoined twins are candidates for separation surgery, CHOPs pediatric surgical team (which may include general surgeons, plastic and reconstructive surgeons, neurosurgeons, and other surgical specialties) will work with a multidisciplinary team to monitor the babies and determine the timeline and approach for the surgical procedure. […] Not all conjoined twins are candidates for separation, and the success rates for separating conjoined twins vary depending on the connection. […] Childrens Hospital of Philadelphia has successfully separated 32 pairs of conjoined twins, the first in 1957.

• #1 Conjoined Twins – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560839/

  Conjoined twins that survive until birth can be broadly categorized into two categories, those who can be surgically separated and those who cannot. The determination of which set of conjoined twins can be separated is an interprofessional effort employing imaging modalities and multiple reviews. The conjoined twins that extensively share vital organs can generally not be separated as separation might lead to the death of one or both twins. This presents some ethical dilemmas in the surgical management of conjoined twins, but the overall decision still lies with the parents. Some cases might need the involvement of the hospital ethics committee. […] Surgical management requires identification of the anatomic relationship of the conjunction between the twins. Three-dimensional modeling and simulations help the team in making surgical decisions. The use of tissue expansion preoperatively is very helpful due to issues with the closure of the abdominal wall. At least 1 simulation of the separation event is recommended preoperatively as that helps with the outcome of conjoined twins. […] During medical management, some pharmacokinetic considerations must be kept in mind as the shared circulation of the conjoined twins may have a variable volume of distribution and clearance. […] The management of conjoined twins requires the intimate cooperation of an interprofessional team.

• #1 Conjoined Twins: Definition, Causes & Outlook

  https://my.clevelandclinic.org/health/diseases/22895-conjoined-twins

  Conjoined twins are rare. Complications can be reduced with close management from healthcare professionals. […] Successful management usually involves several medical and surgical specialists. […] The decision to attempt separation or not can bring up difficult ethical questions. […] In some cases, it’s possible to separate conjoined twins. […] The procedure to separate twins always takes extensive planning by a team of highly experienced surgeons. […] If separation surgery is attempted, only 60% of surgically separated conjoined twins survive. Healthcare providers can manage complications to improve the outlook for conjoined twins. […] Treatment of conjoined twins depends on where they’re conjoined and the extent of organ sharing. But there are surgical and medical options for many conjoined twins who survive birth.

• #1 A first-ever separation of conjoined twins | Summer 2021 | UC Davis Health Magazine

  https://health.ucdavis.edu/health-magazine/issues/summer2021/noteworthy/a-first-ever-separation-of-conjoined-twins.html

  After months of intense planning and practice, surgeons at UC Davis Childrens Hospital successfully separated nine-month-old conjoined twins Abigail and Micaela Bachinskiy in a marathon surgery this past October. […] The 24-hour surgery the first separation of conjoined twins at UC Davis Medical Center took place in a UC Davis Childrens Surgery Center operating room custom-built for the procedures high complexity. […] Surgeons decided to separate the twins at nine months, both to keep shared blood vessels and organs from developing further and to allow for adequate tissue expansion for later coverage of the defect after separation. […] In June, Wongs team placed custom designed tissue expanders under the skin of the girls heads, to encourage enough skin growth for skull coverage upon separation. […] 3-D printing allowed generation of multiple models of the twins fused skulls, useful for precision planning and practice. […] Surgical challenges included dividing large veins and brain matter that connected the twins so they could have independent circulatory systems.

• #1 Conjoined Twins | Obstetrics & Gynecology

  https://www.obgyn.columbia.edu/patient-care/our-centers/center-prenatal-pediatrics/conditions-we-care/conjoined-twins

  Conjoined twins are diagnosed by ultrasound, and the condition can be further characterized with the use of fetal echocardiography and MRI. […] Some conjoined twins may be candidates for operations after birth that attempt to separate the twins, although survival is not always possible. In many cases, surgical separation may not be possible.

• #1 3-Year-Old Conjoined Twins with Fused Brains Separated in Brazil

  https://people.com/health/conjoined-twins-with-fused-brains-separated-in-historic-virtual-reality-surgery/

  A neurosurgeon from England has successfully separated two Brazilian twins who were conjoined at the head. […] The procedures, which Jeelani called a „remarkable achievement,” required medical professionals to master virtual reality training programs for months before they actually attempted the surgeries in real life. […] „The successful separation of Bernardo and Arthur is a remarkable achievement by the team in Rio and a fantastic example of why the work of Gemini Untwined is so valuable,” Jeelani added in a statement obtained by The Independent. […] „Our mission is to offer hope and medical solutions to challenges faced by craniopagus children and others with complex craniofacial conditions,” reads Gemini Untwined’s website. „To further global health equity and access, enabling the treatment of children and the training of medical teams across the world; and to continue to push the boundaries of medical innovation and research.”

• #1 Conjoined Twins – Types, Causes, Signs & Treatment

  https://parenting.firstcry.com/articles/conjoined-twins-causes-signs-and-treatment/

  The treatment for conjoined twins may vary depending upon how they are physically joined and which all internal organs they share. By carefully observing, your doctor may advise you any of the following treatment options: […] If you are carrying conjoined twins, your doctor will monitor your health closely during pregnancy. You can refer other specialists apart from your doctor to figure out the best treatment plan for your twins. […] Normal delivery is not feasible in the case of conjoined twins. Therefore, your doctor will suggest you for C-section or cesarean delivery. You will be operated much before your due date, generally two to four weeks prior to your due date. After the babies are born, their overall health is evaluated, and then further treatment plans are made. […] Conjoined twins surgery may be suggested to you to separate your twin babies. Any kind of surgical procedure to separate the conjoined twins is usually performed two to four months after the birth. Sometimes emergency separation surgery may also be required. The doctor may consider the following factors before recommending surgery:

• #1 Conjoined Twins | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/conjoined-twins/

  Conjoined twins can be delivered by cesarean section at our state-of-the-art facility, where our team specializes in managing this condition. […] Treatment options for conjoined twins varies from case to case. The Colorado Fetal Care Center works closely with the parents to identify the best treatment plan for their babies. […] Conjoined twin treatment options vary based on where and how the babies are joined. […] Twins whose lives are immediately threatened, especially those connected at the chest or head, require emergency surgery before extensive diagnostics can be completed. […] Significant ethical considerations arise in cases where it is not possible to achieve separation without sacrificing the life or the quality of the life of one of the two twins. […] Your physicians will assess your case with a high degree of detail through multiple diagnostic tests and create a treatment plan aimed at maximizing your children’s health and quality of life.

• #1 Conjoined Twins: Development, Delivery, and Separation

  https://www.healthline.com/health/conjoined-twins

  Conjoined twins are rare and face a number of health challenges before and after birth. […] If they survive to infancy, some conjoined twins may be surgically separated, depending on how theyre connected and what organs they share. […] After delivery, the twins may need care in the neonatal intensive care unit (NICU). Experts share that around 25% of conjoined twins survive long enough to be considered for separation surgery. […] That said, separation depends on where the twins are joined and which vital organs are shared. This means that some twins may be separated while others cant be separated. […] Separation surgery is undergone on a case-by-case basis when the twins are between 3 months old and 3 years old. […] Theres no standard treatment for conjoined twins. Instead, your doctor will take into consideration the babies health and any other special circumstances that are unique to their physical connection. […] Options might include: physical therapy, occupational therapy, specialized devices to help with mobility.

• #1 Turkish doctors successfully separate 8-month-old conjoined twins from Pakistan in marathon 14-hour surgery

  https://www.aa.com.tr/en/asia-pacific/turkish-doctors-successfully-separate-8-month-old-conjoined-twins-from-pakistan-in-marathon-14-hour-surgery/3334391

  A team of 60 medical professionals in the Turkish capital Ankara successfully separated 11-month-old conjoined twins from Pakistan after complex, two-stage operations lasting some 14 hours. […] The separation was done in two stages. The surgical team was led by Dr. Jeelani, along with Turkish physicians Dr. Harun Demirci and Dr. Hasan Murat Ergani. […] The final 14-hour operation took place on July 19, successfully separating the twins, who were conjoined at the skull. […] The babies had some issues with sitting and hand movements due to their conjoined state. Post-surgery, our neurologists, physical therapists and neurodevelopmental specialists resolved these issues, he said. […] Detailing the process, reconstructive physician Ergani said: To prevent tissue deficiency after the separation, we first performed balloon tissue expansion surgery.

• #1 Conjoined Twins Story | Wolfson Children’s | Jacksonville, FL

  https://www.wolfsonchildrens.com/services/gastroenterology/twins-gastro-story

  Immediately after their birth, the twins underwent emergency surgery to repair a potentially life-threatening condition called a ruptured omphalocele, in which their shared small intestine protruded through a weak area of the abdominal wall. […] After that, the boys underwent an additional surgery to remove the temporary mesh where surgeons then partially separated the shared small intestine to enable the babies to feed orally. […] During the procedure, it was discovered that the boys had two bile ducts that also were fused. Conner and Carters livers and bile ducts were left intact for the May separation surgery.

• #1 Conjoined twins | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/conjoined-twins

  Treatment of conjoined twins depends on their unique situation their health issues, where they’re joined, whether they share organs or other vital structures, and other possible complications. […] If you’re carrying conjoined twins, you’ll likely be closely monitored throughout your pregnancy. You’ll likely be referred to a maternal and fetal medicine specialist in high-risk pregnancy. […] After your conjoined twins are born, they’re fully evaluated. With this information, you and your health care team can make decisions regarding their care and whether separation surgery is appropriate. […] If a decision is made to separate the twins, separation surgery is usually done around 6 to 12 months after birth to allow time for planning and preparation. […] Many complex factors must be considered as part of the decision to do separation surgery. Each set of conjoined twins presents a unique set of issues due to differences in body structure and function.

• #1 Conjoined Twin Types and Treatment

  https://www.verywellhealth.com/conjoined-twins-5210361

  Conjoined twins can be treated or even separated, though. The prognosis for separating conjoined twins depends on where their bodies are connected. […] There are many factors that go into a decision to perform separation surgery, including the extent of shared organs and the surgeries that will be required to reconstruct body parts after separation surgery. […] Not all conjoined twins are candidates for surgery, such as when the babies share a heart. Separation surgery is a very complex procedure that requires multiple healthcare professionals with varying areas of expertise. […] Between 50% and 90% of separation surgeries are successful but it depends on the organs involved. […] However, continuing advances in surgical procedures have led to successful separation surgeries. […] It’s equally important to consider physical therapy, occupational therapy, mental health treatment, and other services that may be part of conjoined twin care. […] The prognosis for conjoined twins is not good. Many do not survive in utero or they die shortly after birth. However, separation surgery can be performed successfully in some cases.

• #1 Conjoined Twins: Types, Causes, Survival & Life Expectancy

  https://www.webmd.com/baby/what-are-conjoined-twins

  Some conjoined twins can be separated. Childrens Hospital of Philadelphia (CHOP) has successfully separated 32 pairs of conjoined twins since 1957. […] „To determine if conjoined twins can be safely separated, we study their shared structures using detailed imaging,” says Holly L. Hedrick, MD, an attending pediatric and fetal surgeon in the Division of Pediatric General, Thoracic and Fetal Surgery at Children’s Hospital of Philadelphia (CHOP). […] The best outcome is when conjoined twins can be safely separated, but not all conjoined twins can be separated. […] Most conjoined twins need a lot of medical care to help manage their long-term health. […] Not all conjoined twins are good candidates for surgery to separate them. For twins who share vital organs such as a heart, surgery isn’t an option.

• #1 The Story of Addy and Lily: Birth and Separation of Conjoined Twins | Children’s Hospital of Philadelphia

  https://www.chop.edu/stories/story-addy-and-lily-birth-and-separation-conjoined-twins

  Lily and Addy Altobelli underwent separation surgery at Children’s Hospital of Philadelphia in October 2021. […] CHOP is one of only a few hospitals in the country with experience separating conjoined twins. […] The evaluation found that while the girls were joined at the chest wall, diaphragm and liver, they each had separate, healthy hearts. […] This meant they were excellent candidates for separation surgery. […] Taking care of conjoined twins involves so many overlapping teams, says Dr. Hedrick. […] The physical and occupational therapy teams at CHOP were constantly coming up with creative ways to help the twins continue to develop, despite being conjoined. […] As a first step, CHOP plastic surgeon, David Low, MD, inserted skin expanders in each infant. […] On October 13, 2021, after months of preparation, Addy and Lily underwent a 10-hour surgery that included dozens: nurses, anesthesiologists, a cardiothoracic surgeon, general surgeons, plastic surgeons, radiologists and more. […] Following surgery, the girls spent seven weeks in CHOPs PICU and did amazingly well. […] The expectation is that they will continue to thrive.

• #1 Conjoined Twins – Seattle Children’s

  https://www.seattlechildrens.org/conditions/conjoined-twins/

  More conjoined twins survive now than in the past. This is a result of advances in imaging studies, surgical techniques and anesthesia. […] Our treatment goal is to give both children the best chance for a good quality of life. Sometimes surgery to separate the twins is the best option. The success of the separation surgery depends on many factors, mainly where the twins are connected and which structures they share. […] Sometimes separation surgery is not possible. Some conjoined twins have happy, healthy, full lives by staying connected. […] Treatment for each set of twins is unique. The connection between the twins bodies may range from fairly simple to very complex. […] Your twins healthcare team will do tests during pregnancy and after birth to learn as much as they can about your babies anatomies and how well their bodies are working. The team uses this information to create a detailed treatment plan. Our goal is to give both children the best chance for a good quality of life, whenever possible.

• #1 Conjoined twins – Wikipedia

  https://en.wikipedia.org/wiki/Conjoined_twins

  Surgery to separate conjoined twins may range from very easy to very difficult depending on the point of attachment and the internal parts that are shared. Most cases of separation are extremely risky and life-threatening. Though there have been a number of successful separations throughout history, in many cases, the surgery results in the death of one or both of the twins, particularly if they are joined at the head or share a vital organ. This makes the ethics of surgical separation, where the twins can survive if not separated, contentious. […] The first recorded separation of conjoined twins took place in the Byzantine Empire in the 900s. One of the conjoined twins had already died, so the doctors of the town attempted to separate the dead twin from the surviving twin. The result was briefly successful, as the remaining twin lived for three days after separation.

• #1

  https://journals.lww.com/ajps/fulltext/2023/20030/conjoined_thoracopagus_twins__a_systematic_review.2.aspx

  Conjoined twin is an extremely rare condition and requires a thorough knowledge of anatomy, and a multidisciplinary approach is essential to successfully separate the twins. […] The most important decisive parameter for successful separation is the extent of sharing of organs between twins. The role of a motivated multidisciplinary team is also indispensable and cannot be overemphasised. […] The overall success rate of separation is around 50.6%. […] The separation of conjoined twins is a challenging process and requires a multidisciplinary team approach. […] The optimal time for surgical separation is 3 months as in our case, however, it may be extended up to 3 years depending upon individual cases. […] The reported survival rate in previous literature for emergency separation of conjoined twins is around 30% while that of elective separation reaches up to 80%.

• #1 Turkish doctors perform successful 14-hour surgery to separate conjoined twins from Pakistan

  https://tribune.com.pk/story/2497444/turkish-doctors-perform-successful-14-hour-surgery-to-separate-conjoined-twins-from-pakistan

  A team of 60 medical professionals in Ankara, Turkey, successfully separated 11-month-old conjoined twins from Pakistan in a complex two-stage surgery that lasted approximately 14 hours. […] The final stage of the surgery, which separated the twins, was completed on July 19. […] Dr. Ergani described the two-part surgery, explaining that a tissue expansion procedure was done prior to the separation to prevent any issues with tissue deficiency. […] The second stage involved the separation, which required precise planning to avoid complications. […] Jeelani praised Turkey, the Ministry of Health, and the medical staff for their support, calling the successful surgery an example of global unity and cooperation.

• #1 Inside the Successful Separation Surgery of Conjoined Twins | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/inside-successful-separation-surgery-conjoined-twins

  A procedure this complex really benefits from the collective clinical expertise at NewYork-Presbyterian Morgan Stanley Childrens Hospital, says Thomas Imahiyerobo, MD, director of cleft and craniofacial surgery. Everyone from the nurses to the surgeons to the critical care team was committed to making the separation of these two girls a reality. […] To prepare for the complex separation procedure, the multidisciplinary team held meetings and surgery simulations to map out the steps of the well-choreographed separation surgery. […] Before the conjoined twins separation, the girls underwent a preliminary procedure to place tissue expanders into the abdominal wall, which would slowly stretch the babies skin over the course of six weeks. […] When the day of the separation surgery arrived, the surgical teams led by Imahiyerobo, Kato, Stylianos, and Bacha were laser-focused on doing everything we could to ensure our ultimate goal, which was two healthy, separated twins, says Imahiyerobo.

• #1 Conjoined twins separated at SJD Barcelona Children’s Hospital

  https://www.sjdhospitalbarcelona.org/en/news/conjoined-twin-girls-are-successfully-separated-sjd-barcelona-childrens-hospital

  This allows the surgical team to plan the surgery in detail and practice the technique before the actual operation. […] With this in mind, teams on the Simulation Programme and in the 3D Unit at the Hospital created a to-scale virtual 3D replica of the twins, which allowed surgeons to decide which approach would be best for the operation and practice it. […] One week before the operation, the simulation took place. […] The aim was to reproduce not only the surgical procedure that was to take place, but also the physical space. […] We had to have two operating tables in the one theatre to properly finish the procedure on both girls separately, to reconstruct their abdominal wall and close the wound, explains Xavier Tarrado, Head of Pediatric Surgery at the SJD Barcelona Children’s Hospital.

• #1 Conjoined Twins Story | Wolfson Children’s | Jacksonville, FL

  https://www.wolfsonchildrens.com/services/gastroenterology/twins-gastro-story

  Carter and Conner, conjoined twin boys born Dec. 2014, in Jacksonville, Fla., underwent a successful 12-hour separation surgery in May 2015. […] The separation involved a 17-member surgical care team, including Stephen Dunn, MD, Division Chief of Solid Organ Transplant, for Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., who traveled to Jacksonville to assist the team in separating Conner and Carters fused livers. […] Leading up to the surgery, the twins integrated care team spent months preparing for the complexities of this separation, including MRI studies, a medical illustration of the conjoined areas, clinical and logistical simulations of the final separation surgery and specific procedures, and keeping the boys as healthy and strong as possible considering their multiple medical challenges.

• #1 Separating conjoined twins is a stressful, high-risk operation. It’s why I went into medicine | As told to Sarah Johnson | The Guardian

  https://www.theguardian.com/society/2019/sep/19/separating-conjoined-twins-stressful-high-risk-operation-why-medicine

  Separating conjoined twins is a stressful, high-risk operation. […] The operation to separate conjoined twins is very high-risk. […] When the last connection between the twins was separated there were two individual patients, and each twin was no longer dependent on the other for their survival. […] This type of operation is not something you do every day.

• #1 Conjoined Twins | Pediatric Surgery NaT

  https://www.pedsurglibrary.com/apsa/view/Pediatric-Surgery-NaT/829673/all/Conjoined_Twins

  It is also crucial to consider that separation is a team effort. While in the past a single surgeon may have taken on these cases and dealt with both babies, the complexities of union and the specifics of separation call for expertise in a number of areas including general, thoracic, cardiac, orthopedic, urologic, neurosurgical and plastic surgery. Careful coordination of services in neonatology, radiology and even media control are essential to providing care for these infants. One person needs to be the lead surgeon and coordinate all of the facets of care that come into play.

• #1

  https://www.westchestermedicalcenter.org/blogs/conjoined-twins-successfully-separated-at-maria-fa-142

  In January, the first separation of conjoined twins ever performed at Maria Fareri Childrens Hospital, a member of the Westchester Medical Center Health Network, was successfully completed. […] A team of more than 50 medical professionals separated 11-month-old twin girls Ballenie and Bellanie Camacho during a complex 21-hour procedure. […] Pediatric surgeon Samir Pandya, MD, who, with Whitney McBride, MD, led the surgical teams, says, Their attachment presented us with many challenges, but after a successful separation, these twins now have a chance for better lives. […] The separation of Ballenie and Bellanie was a significant undertaking, which was successful due to the skill, dedication and tireless preparation of our teams, said Michael Gewitz, MD, William Russell McCurdy Physician-in-Chief at Maria Fareri Childrens Hospital. The girls can now live independent lives, and we couldnt be happier.

• #1 Conjoined twins – twenty years’ experience at a reference center in Brazil | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-conjoined-twins-twenty-years–S1807593222020762

  This study reports on the experience of one hospital regarding the surgical aspects, anatomic investigation and outcomes of the management of 21 conjoined twin pairs over the past 20 years. […] A detailed anatomic study of the twins and surgical planning must precede separation. A well-prepared pediatric surgery team is sufficient to surgically manage conjoined twins. […] The surgical separation of conjoined twins is now the principal aim of all medical teams who treat this uncommon condition. However, separation presents both surgical and anesthetic challenges. […] The separation procedure was always performed by a single surgical team. […] Among the 21 sets of conjoined twins, 12 underwent separation surgery (seven ischiopagus, three omphalopagus, one thoracopagus and one craniopagus).

• #1 Conjoined twins – Wikipedia

  https://en.wikipedia.org/wiki/Conjoined_twins

  In 1955, neurosurgeon Harold Voris and his team at Mercy Hospital in Chicago performed the first successful operation to separate craniopagus twins (conjoined at the head), which resulted in long-term survival for both. […] Recent successful separations of conjoined twins include that of the separation of Ganga and Jamuna Shrestha in 2001, who were born in Kathmandu, Nepal, in 2000. […] Infants Rose and Grace Attard, conjoined twins from Malta, were separated in the United Kingdom by court order over the religious objections of their parents. […] In 2003, two 29-year-old women from Iran, Ladan and Laleh Bijani, who were joined at the head but had separate brains, were surgically separated in Singapore, despite surgeons’ warnings that the operation could be fatal to one or both. […] In 2019 Safa and Marwa Ullah were separated at Great Ormond Street Hospital in London, England. The surgery presented particular difficulties due to a number of shared veins and a distortion in the shape of the girls’ brains, causing them to overlap.

• #1 Parting is bittersweet for formerly conjoined twins | News Center

  https://med.stanford.edu/news/all-news/2008/01/parting-is-bittersweet-for-formerly-conjoined-twins

  Fiorella (far left) and Yurelia Rocha-Arias (next left) sit side-by-side, next to a mirror, during physical therapy at Lucile Packiard Children’s Hospital. The twins, born conjoined, were separated by Nov. 12. […] The physical connection is now gone, thanks to the efforts of an extraordinary number of people at Lucile Packard Children’s Hospital. […] The nonprofit organization Mending Kids International was looking for a hospital with the expertise to separate the girls’ shared liver and fused hearts. […] Without separation the girls would never walk normally or spend time apart. […] The girls were separated on Nov. 12 in a nine-hour procedure that was most remarkable for its lack of complications. […] The most exciting moment, Boltz recalls of the separation surgery, was in the final stage of the separation, when surgeons placed a clamp on the connection between the girls’ hearts.

• #1

  https://abc7ny.com/post/twin-brothers-born-conjoined-celebrate-1st-birthday-after-separation-surgery/15408025/

  Amari and Javar spent the first 10 months of their lives hospitalized at Children’s Hospital of Philadelphia, where doctors and nurses prepared diligently for their separation surgery. […] Dr. Holly L. Hedrick, a pediatric general and fetal surgeon at the hospital, said doctors were hopeful for a successful surgery, in part, because Amari and Javar did not share a heart. […] On the day of the surgery, Aug. 21, 2024, a surgical team of more than two dozen specialists, including surgeons, anesthesiologists, radiologists, nurses and many others, operated for eight hours, according to Children’s Hospital of Philadelphia. The brothers’ abdomens were then rebuilt using layers of mesh and plastic surgery techniques. […] Both Amari and Javar are now home with their parents and siblings and are continuing to receiving therapies including speech therapy and physical therapy. […] The Ruffins said that after a nearly two-year journey from diagnosis to separation, they’ve learned to always seek a second opinion and to advocate for their sons.

• #1 Inside the Successful Separation Surgery of Conjoined Twins

  https://healthmatters.nyp.org/inside-the-successful-separation-surgery-of-conjoined-twins-we-are-so-grateful/

  Alusine and Isatu Jalloh traveled 4,300 miles from home to give their girls the chance for a better life. […] A team of leading surgeons and specialists successfully separated the conjoined twins at NewYork-Presbyterian Morgan Stanley Childrens Hospital. […] Their opportunity arrived on February 21, 2020: With a mix of nerves and excitement, hope and fear, Alusine and Isatu took a step back from their daughters bed and watched as nurses rolled the girls on a gurney down the corridor toward the operating room at NewYork-Presbyterian Morgan Stanley Childrens Hospital, where they would undergo a rare and life-changing surgery. […] Over the next 9 hours, a team of more than 30 surgeons and specialists, including anesthesiologists, hepatologists, nurses, and technicians, from NewYork-Presbyterian and Columbia University Irving Medical Center would successfully separate Hassanatu and Hussainatu, who were born joined at the abdomen and chest with their liver and the lining of their hearts fused.

• #1 Conjoined twins – twenty years’ experience at a reference center in Brazil | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-conjoined-twins-twenty-years–S1807593222020762

  The mean anesthesia time for the separation surgery was 8 h 45 min4 h 49 min, and the mean surgery time was 6 h 52 min4 h 10 min. […] The reconstruction phase for each separated twin was performed by a reconstruction of the digestive system with intestinal anastomoses, followed by reimplantation of the divided ureters. […] The surgical mortality rate of our series was 33.3%, which is in accordance with other published series. […] Considering the surgical outcomes, it is concluded that a well-prepared pediatric surgery team is sufficient for the surgical management of conjoined twins.

• #1

  https://6abc.com/post/twin-brothers-born-conjoined-celebrate-1st-birthday-month-after-separation-surgery-childrens-hospital-philadelphia/15407888/

  On the day of the surgery, Aug. 21, 2024, a surgical team of more than two dozen specialists, including surgeons, anesthesiologists, radiologists, nurses and many others, operated for eight hours, according to Children’s Hospital of Philadelphia. The brothers’ abdomens were then rebuilt using layers of mesh and plastic surgery techniques. […] Both Amari and Javar are now home with their parents and siblings and are continuing to receiving therapies including speech therapy and physical therapy.

• #1 Story of hope: Turkish doctors separate conjoined twin babies from Pakistan

  https://www.trtworld.com/turkiye/story-of-hope-turkish-doctors-separate-conjoined-twin-babies-from-pakistan-18210007

  Turkish President Recep Tayyip Erdogan personally intervened to ensure that life-saving treatment was given to 11-month-old conjoined twins. […] In a remarkable medical feat, a team of 60 doctors in Ankara worked 14 hours in a surgical room to successfully separate 11-month-old conjoined twins Mirha and Minal. […] The separation surgery, a highly complex and delicate procedure, was carried out in two stages. […] On July 19, the final 14-hour surgery successfully separated the girls, whose skulls had been fused since birth. […] Dr. Aziz Ahmet Surel, the hospital’s coordinating chief physician, highlighted the international collaboration involved, describing it as a „successful transfer of knowledge and expertise” between Turkish and British teams. […] Dr Namik Yasar Ozbek, head of Pediatric Hematology-Oncology, echoed this sentiment, praising the extensive teamwork required to give the twins a new life.

• #1 Conjoined twins – twenty years’ experience at a reference center in Brazil | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-conjoined-twins-twenty-years39-S1807593222020762

  This study reports on the experience of one hospital regarding the surgical aspects, anatomic investigation and outcomes of the management of 21 conjoined twin pairs over the past 20 years. […] A detailed anatomic study of the twins and surgical planning must precede separation. A well-prepared pediatric surgery team is sufficient to surgically manage conjoined twins. […] The surgical separation of conjoined twins is now the principal aim of all medical teams who treat this uncommon condition. However, separation presents both surgical and anesthetic challenges. […] The separation procedure was always performed by a single surgical team. […] Among the 21 sets of conjoined twins, 12 underwent separation surgery (seven ischiopagus, three omphalopagus, one thoracopagus and one craniopagus).

• #1 Conjoined twins – twenty years’ experience at a reference center in Brazil | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-conjoined-twins-twenty-years39-S1807593222020762

  The separation procedure began by making a large longitudinal incision across the anterior abdominal wall. […] The reconstruction phase for each separated twin was performed by a reconstruction of the digestive system with intestinal anastomoses, followed by reimplantation of the divided ureters. […] The last phase of reconstruction was the closure of the abdominal wall. […] The surgical mortality rate of our series was 33.3%, which is in accordance with other published series. […] Considering the surgical outcomes, it is concluded that a well-prepared pediatric surgery team is sufficient for the surgical management of conjoined twins.

• #1 Inside the Successful Separation Surgery of Conjoined Twins | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/inside-successful-separation-surgery-conjoined-twins

  When the surgical teams successfully separated the girls bodies, we had a magical moment where we took the two girls who were sharing one table and we brought them onto two separate tables. That was the first time they were physically in a separate space, says Imahiyerobo, who called Isatu and Alusine from the OR to share the news. […] The care team performed a series of surgeries to ensure the optimal placement and performance of Chelsea’s heart inside her new body and to repair the area of pericardial lining that she was missing. […] The girls used feeding tubes as they underwent speech and swallowing therapy because after major surgery, it’s not unusual that young children forget how to eat and lose muscle coordination, says Martinez. […] More than a year after their separation surgery, the girls are thriving. They are growing and making progress in achieving developmental milestones, says Martinez. They both have an opportunity to go forward from here, reaching new heights individually, each as her own person, which never could have been possible without the separation surgery.

• #1 Conjoined Twins: Types, Causes, Survival & Life Expectancy

  https://www.webmd.com/baby/what-are-conjoined-twins

  Elective separation surgery is very complicated. […] Children will need specialized follow-up care, including physical and occupational therapy. […] Of the conjoined twins who do survive, only 25% live long enough to be candidates for surgery. Also, only about 60% of surgically separated twins survive. […] More conjoined twins are surviving today than in the past, thanks to improvements in imaging studies and surgical techniques.

• #1 Conjoined twins – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conjoined-twins/diagnosis-treatment/drc-20353915

  Recent advances in imaging before birth, critical care and anesthetic care have improved outcomes in separation surgery. […] After separation surgery, pediatric rehabilitation services are crucial to help the twins develop properly. […] If separation surgery isn’t possible or if you decide not to have the surgery done, your team can help you meet the medical care needs of your twins. […] If the circumstances are grave, medical comfort care such as nutrition, fluids, human touch and pain relief is provided. […] If you’re pregnant with conjoined twins, you’ll be referred to a team of specialists to help guide you and create a treatment plan for your twins. […] Your health care provider and other members of your health care team review your conjoined twins’ tests and exam results and discuss options with you.

• #1 Parting is bittersweet for formerly conjoined twins | News Center

  https://med.stanford.edu/news/all-news/2008/01/parting-is-bittersweet-for-formerly-conjoined-twins

  The girls have recovered very well from the separation and their subsequent operations: repairing Yurelia’s congenital cardiac condition and reconstructing Fiorella’s chest closure and mending her skin flap. […] The twins progressed very well and left our cardiovascular intensive care unit at the end of November. […] They’ve received regular physical and occupational therapy to help them learn to move and walk apart since their separation in November. […] Child psychiatrist Richard Shaw, MD, and his colleagues, have been working with the twins and their mother. […] Their behavior changed after their separation. […] Although the twins and their separation will leave a lasting memory in the minds of all those here who participated in their care, no one is happier than their mother.

• #1 Parasitic Twins: Causes, Symptoms, and Treatment

  https://www.webmd.com/baby/what-are-parasitic-twins

  Can Parasitic Twins Be Treated? […] The only possible treatment for a parasitic twin is surgical excision (removal). […] During the surgery, the doctor removes all of the parts belonging to the parasitic twin from the dominant one. […] Thanks to modern advancements in surgical techniques, most babies dont have any immediate postoperative complications. […] Like any surgery, the removal of a parasitic twin can cause several complications. […] However, its important to remember that most babies with parasitic twins have a positive medical outlook.

• #1 Inside the Successful Separation Surgery of Conjoined Twins

  https://healthmatters.nyp.org/inside-the-successful-separation-surgery-of-conjoined-twins-we-are-so-grateful/

  The girls used feeding tubes as they underwent speech and swallowing therapy because after major surgery, it’s not unusual that young children forget how to eat and lose muscle coordination, says Dr. Martinez. […] More than a year after their initial separation surgery, the girls are thriving. They are growing and making progress in achieving developmental milestones, says Dr. Martinez. […] A chance for a better life is all Isatu and Alusine ever wanted for their daughters.

• #1 3-Year-Old Conjoined Twins with Fused Brains Separated in Brazil

  https://people.com/health/conjoined-twins-with-fused-brains-separated-in-historic-virtual-reality-surgery/

  The twins will go through six months of rehabilitation following the surgeries and are recovering in the hospital, the charity told The Independent. […] In the three years since Gemini Untwined’s founding, the organization told PEOPLE that it has performed six surgeries separating craniopagus twins, which it said „is more than any one organization.” All twelve children involved in the surgeries have survived, it said.

• #1 Conjoined twins | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/conjoined-twins

  Recent advances in imaging before birth, critical care and anesthetic care have improved outcomes in separation surgery. After separation surgery, pediatric rehabilitation services are crucial to help the twins develop properly. Services may include physical, occupational and speech therapies and other assistance as needed. […] If separation surgery isn’t possible or if you decide not to have the surgery done, your team can help you meet the medical care needs of your twins. […] If the circumstances are grave, medical comfort care such as nutrition, fluids, human touch and pain relief is provided.

• #1 Therapy services and specialized devices for conjoined twins: Unique challenges with conjoined twins and the importance of physical and occupational therapy – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30166054/

  Conjoined twins are a rare occurrence that offer unique challenges and circumstances to therapists. The overall goal of physical and occupational therapy treatment is to provide care that promotes developmental progression to two conjoined individuals with distinct personalities and potentially different physical and medical needs. […] The unique presentation of conjoined twins must be considered in determining therapeutic goals, interventions and plans of care. Providing therapeutic interventions throughout the NICU stay is a dynamic, evolving process, which challenges the therapy team to work together to find solutions. This paper aims to highlight the considerations, challenges, and strategies used to address barriers in the therapeutic care of conjoined twins.

• #1 Families celebrate GOSH’s Conjoined Twins Day | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/news/families-celebrate-goshs-conjoined-twins-day/

  Six sets of twins came together to be seen by their different teams on Great Ormond Street Hospitals Conjoined Twins Day. […] The Specialist Neonatal and Paediatric Surgery (SNAPS) team arranged the day so that the twins and their families had chance to meet each other, and in some cases be reunited. […] Since then, over 38 sets of conjoined twins have been cared for at GOSH separating more twins than anywhere in the world. […] Some of the more complex surgeries can take over 15 hours and need to be done in two separate theatre rooms at GOSH. […] The teams also include dedicated paediatricians, ward nurses and allied health professionals including physiotherapists, occupational therapists, dietitians, speech and language therapists, and the Play team, who all perform a vital part in the care and rehabilitation following the operations.

• #1 Conjoined Twins – Seattle Children’s

  https://www.seattlechildrens.org/conditions/conjoined-twins/

  Whether to do surgery to separate your twins depends on their chance of survival and quality of life for each baby. […] Surgery may be the best option: For the physical health of both children, while also giving them the chance to have independent bodies and lives […] Usually, twins have separation surgery in the first 3 months to 12 months of life. The success of the separation surgery depends on many factors, mainly where the twins are connected and which structures they share. […] Whether they stay connected or are separated, your twins will need long-term follow-up visits during childhood and into their early adult years. The healthcare team will check your childrens growth and development. We care for any long-term medical issues they might have. […] Seattle Childrens is one of the nations most experienced hospitals in treating conjoined twins. Care starts during pregnancy, as we monitor your twins health, learn as much as we can about their condition and plan for their care after birth. […] Our team has the knowledge, experience and facilities to: Determine which treatment is likely to give your babies the best quality of life […] Provide care for your conjoined twins if they cannot be separated or your family decides not to separate them.

• #1 (PDF) Therapy services and specialized devices for conjoined twins: Unique challenges with conjoined twins and the importance of physical and occupational therapy

  https://www.academia.edu/128362104/Therapy_services_and_specialized_devices_for_conjoined_twins_Unique_challenges_with_conjoined_twins_and_the_importance_of_physical_and_occupational_therapy

  Conjoined twins are a rare occurrence that offer unique challenges and circumstances to therapists. The overall goal of physical and occupational therapy treatment is to provide care that promotes developmental progression to two conjoined individuals with distinct personalities and potentially different physical and medical needs. The unique presentation of conjoined twins must be considered in determining therapeutic goals, interventions and plans of care. Providing therapeutic interventions throughout the NICU stay is a dynamic, evolving process, which challenges the therapy team to work together to find solutions. This paper aims to highlight the considerations, challenges, and strategies used to address barriers in the therapeutic care of conjoined twins. […] The separation of conjoined twins presents a unique challenge to many pediatric surgical specialties. Meticulous preoperative investigations, planning and multidisciplinary team approach led by pediatric surgeon contribute to the success of surgical separation.

• #1 Conjoined Twins Separated at Le Bonheur

  https://www.commercialappeal.com/picture-gallery/news/local/2016/11/16/conjoined-twins-separated-at-le-bonheur/93954156/

  During a physical therapy session, 16-month-old twins, Testimony and Miracle Ayeni, work on improving their motor skills. […] The twins were successfully separated in an operation at Le Bonheur Children’s Hospital last year. […] Conjoined twin girls Miracle and Testimony Ayeni, of Nigeria, were successfully separated in an 18-hour surgery at Le Bonheur Children’s Hospital. […] A team of pediatric surgeons and specialists at Le Bonheur Children’s Hospital separated 12-month-old conjoined twin girls, Miracle and Testimony Ayeni during a complex, 18-hour procedure. […] During a press conference at Le Bonheur Children’s Hospital, pediatric surgeon Trey Eubanks talks about some of the issues involved in separating the conjoined twins Miracle and Testimony Ayeni. […] During a press conference at Le Bonheur Children’s Hospital, orthopedic specialist William Warner talks about some of the issues involved in separating the conjoined twins Miracle and Testimony Ayeni.

• #1 Conjoined Twins | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/conjoined-twins

  While some conjoined twins can be surgically separated, this is not always feasible, especially when vital organs are shared. […] Some conjoined twins can easily be separated through surgery, allowing both twins to live separate lives. […] For other twins, this may not be an option, or it may be one fraught with great risk, as in cases where conjoined twins are connected by vital organs such as the liver, heart, or brain, or when they share major blood vessels. […] In very unfortunate cases, surgery to separate conjoined twins may be necessary in order to save their lives, but it may also require the sacrifice of one twin. […] This can create complicated ethical and legal dilemmas for the twins, their family, and the medical personnel charged with administering to their needs. […] Asymmetrical conjoined twins have a much lower chance of mutual, independent viability, meaning that the most likely outcome is that they will have to remain conjoined throughout their lives, or that if they are separated (through agreement or necessity), only the more fully developed twin will survive.

• #1 Reflections on Conjoined Twins | Psychology Today

  https://www.psychologytoday.com/us/blog/twofold/202406/reflections-on-conjoined-twins

  Conjoined twins occur in about one in 200 identical twin births. […] The mission of Gemini Untwined is providing hope and treatment for cranially conjoined twins globally through pioneering research and treatment (Gemini Untwined, 2023). […] In summary, medical technology is becoming increasingly advanced, enabling more conjoined twins to be detected, to survive, and to be separated. Of course, not all conjoined twins can withstand surgical procedures, but they may survive if they stay connected.

• #1 Conjoined Twins – Types, Causes, Signs & Treatment

  https://parenting.firstcry.com/articles/conjoined-twins-causes-signs-and-treatment/

  In a case where separation surgery is not feasible or the parents decide not to go ahead with the surgery, your doctor and other specialists can give suggestions on how to live a normal life with conjoined twins. There are many cases where conjoined twins are not separated and they spend their life staying connected. […] Either the twins stay connected or are separated from each other; they will have to keep going for regular medical check-ups. In most cases, surgery or other methods of treatments are suggested, which require regular monitoring by the doctors.

• #1 Mayo Clinic Health Library – Conjoined twins | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20194203

  Many complex factors must be considered as part of the decision to do separation surgery. Each set of conjoined twins presents a unique set of issues due to differences in body structure and function. […] Recent advances in imaging before birth, critical care and anesthetic care have improved outcomes in separation surgery. After separation surgery, pediatric rehabilitation services are crucial to help the twins develop properly. Services may include physical, occupational and speech therapies and other assistance as needed. […] If separation surgery isn’t possible or if you decide not to have the surgery done, your team can help you meet the medical care needs of your twins.

• #1 Conjoined twins – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conjoined-twins/symptoms-causes/syc-20353910

  Conjoined twins may be joined at one of several places. […] Though many conjoined twins are not alive when born (stillborn) or die shortly after birth, advances in surgery and technology have improved survival rates. Some surviving conjoined twins can be surgically separated. The success of surgery depends on where the twins are joined and how many and which organs are shared. It also depends on the experience and skill of the surgical team. […] Possible complications depend on where the twins are joined, which organs or other parts of the body they share, and the expertise and experience of the health care team. When conjoined twins are expected, the family and the health care team need to discuss in detail the possible complications and how to prepare for them. […] Therapy services and specialized devices for conjoined twins: Unique challenges with conjoined twins and the importance of physical and occupational therapy.

• #1 Conjoined Twins | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/81614

  During medical management, some pharmacokinetic considerations must be kept in mind as the shared circulation of the conjoined twins may have a variable volume of distribution and clearance.[13] […] The approach to the management of conjoined twins is complicated. Conjoined twins can be separated into the following groups with regards to prognosis: […] This type of classification may be preferred over anatomic classification because it directs the management specifically. It is also helpful because surgical separation, if applicable, should be performed in infancy. […] The management of conjoined twins requires the intimate cooperation of an interprofessional team.[24]

• #1 P019  Treating conjoined twins | Archives of Disease in Childhood

  https://adc.bmj.com/content/104/7/e2.22

  D and M are conjoined twins born without an antenatal diagnosis and assessed as not suitable for separation. […] Conjoined twins are a rare phenomenon, occurring 1 in 50,000 to 100,000 births. […] Conjoined twins are a complex yet interesting challenge in terms of medication dosage and administration. There is a lack of evidence and dosing has been based on pharmacokinetic principles and adjusted according to clinical response.

• #1 Separation Anxiety – Should Treatment be Imposed for Conjoined Twins? | Practical Ethics

  https://blog.practicalethics.ox.ac.uk/2019/01/separation-anxiety-should-treatment-be-imposed-for-conjoined-twins/

  On the BBC News website this week, there is a feature on a pair of conjoined twins from Senegal who are currently living in Wales. They have an extremely rare condition fused at the lower abdomen they have separate brains, hearts and lungs, but shared liver, bladder and digestive system. […] The twins travelled to the UK to access medical treatment and surgery for their condition, however, the BBC reports that there is concern that both twins would not survive the surgery. […] The best option in this case (as in all cases) would be for the parents and the healthcare team to reach a common understanding about what would be best. […] If parents refuse treatment, doctors should avoid ethical imperialism and be conscious of the values (and decisions) that would apply in the country of origin. […] However, ethical pluralism is not ethical relativism. How much weight we should give to those values, whether that would justify making a different decision for a child born overseas, than for a child born in the UK will require careful unpicking of the reasons in favour and against treatment.

• #1

  https://www.mprnews.org/story/2017/10/28/an-ethical-dilemma-in-a-case-of-conjoined-twins-from-east-africa

  In the East African country where they were born, the conjoined twin girls would likely both have died. […] But even in the wealthiest of nations, it’s not easy to make decisions about how to treat conjoined twins. If surgery is warranted, it is a long and difficult procedure. […] Doctors determined that Twin A, as the paper calls her, suffered from congenital heart disease. Doctors believed she would die with or without the separation surgery. And they further believed that if the twins were not separated and Twin A were to die, Twin B would die soon after because of shared blood circulation. Surgery to separate conjoined twins is not often done. […] Ultimately the choice between letting both children die or operating for the chance of the survival of one „is heavily influenced by culture and values,” the paper says. […] Goldstein says that Twin B, now 3 years old, needs surgery for a deformed leg as well as physical therapy but overall is doing well, „She looks great,” he says. „She’s always happy, smiling.”

• #1 Conjoined Twins | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/81614

  The conjoined twins that survive until birth can be broadly categorized into two categories, those who can be surgically separated and those who cannot. The determination of which set of conjoined twins can be separated is an interprofessional effort employing imaging modalities and multiple reviews. The conjoined twins that extensively share vital organs can generally not be separated as separation might lead to the death of one or both twins. This presents some ethical dilemmas in the surgical management of conjoined twins, but the overall decision still lies with the parents. Some cases might need the involvement of the hospital ethics committee.[11] […] Surgical management requires identification of the anatomic relationship of the conjunction between the twins. Three-dimensional modeling and simulations help the team in making surgical decisions. The use of tissue expansion preoperatively is very helpful due to issues with the closure of the abdominal wall. At least 1 simulation of the separation event is recommended preoperatively as that helps with the outcome of conjoined twins.[12]

• #1 Inside the Successful Separation Surgery of Conjoined Twins

  https://healthmatters.nyp.org/inside-the-successful-separation-surgery-of-conjoined-twins-we-are-so-grateful/

  A procedure this complex really benefits from the collective clinical expertise at NewYork-Presbyterian Morgan Stanley Childrens Hospital, says Dr. Thomas Imahiyerobo, director of Cleft and Craniofacial surgery at NewYork-Presbyterian/Columbia University Irving Medical Center. […] This was a well-coordinated symphony that culminated with each person using their expertise to create this separation and these hopeful little masterpieces, says Dr. Imahiyerobo. […] When the day of the separation surgery arrived, the surgical teams led by Dr. Imahiyerobo, Dr. Kato, Dr. Stylianos, and Dr. Bacha were laser-focused on doing everything we could to ensure our ultimate goal, which was two healthy, separated twins, says Dr. Imahiyerobo. […] The care team performed a series of surgeries to ensure the optimal placement and performance of Chelsea’s heart inside her new body and to repair the area of pericardial lining that she was missing.

• #1 Conjoined twins separated at SJD Barcelona Children’s Hospital

  https://www.sjdhospitalbarcelona.org/en/news/conjoined-twin-girls-are-successfully-separated-sjd-barcelona-childrens-hospital

  It was extremely useful. Thanks to the simulation, the surgical team felt like we had already performed this operation before. […] In the end, the patients had their operation on the 8th of November. […] After the operation, Khadija and Cherive were transferred to the Neonatal Intensive Care Unit and recovered quickly. […] A surgeon from Mauritania, who came to Barcelona to observe the procedure, will monitor the girls when they return home. […] Khadija and Cherives treatment was only possible thanks to the charitable programme Cuidam, run by the SJD Barcelona Children’s Hospital. […] This programme, which is donation-funded, allows children with severe (but curable) diseases who live in low-income countries to come to the SJD Barcelona Children’s Hospital and get the treatment they need, which they cannot access in their home country. […] The goal is for them to return home healthy and with a better quality of life.

• #1

  https://www.dailysabah.com/turkiye/doctors-separate-pakistani-conjoined-twins-in-14-hour-surgery-in-ankara/news

  „When we separated the babies, the tissue to cover the brain was crucial because their brains would be exposed, any complication could harm the children, so we planned very carefully, after we successfully separated the twins, we shared the tissue, he said. […] „Seeing the babies healthy now is an incredible joy. When we successfully separated them, the entire medical team looked at each other and applauded. It was one of the most memorable moments of my life, he added. […] „After reviewing them, Jeelani told us that separation surgery was possible. However, we lacked the financial means for the operation in the U.K. Jeelani then contacted President Erdoan, explained our situation, and thanks to him, the necessary arrangements were made, and we were brought here, Ali added. […] „This is about how the world should be, where when you have children that need help, the whole world comes together, the whole world supports and you get this result for these children,” he said.

• #1 Conjoined twins separated at SJD Barcelona Children’s Hospital

  https://www.sjdhospitalbarcelona.org/en/news/conjoined-twin-girls-are-successfully-separated-sjd-barcelona-childrens-hospital

  This initiative uses private donations to fund treatment for children with severe (but curable) diseases who live in low-income countries and cannot be treated there. […] The campaign to bring Khadija and Cherive was launched immediately. […] Professionals got to work immediately, carrying out various radiodiagnostic tests to confirm the degree to which the twins were conjoined, finding out which organs were shared, and if there were bone and/or blood connections between both girls. […] Testing confirmed that the twins were Omphalopagus, meaning they were joined at near the bellybutton and had two separate livers, but there was a 6 centimetre area of shared tissue. […] For very complex surgical procedures carried out at the SJD Barcelona Children’s Hospital, or for those requiring the involvement of many different professional teams (such as with separating conjoined twins), the Hospital often chooses to simulate the operation beforehand.

• #1 Conjoined Twins – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/services/general-surgery/patient-stories/conjoined-twins.html

  Separation surgery is performed in the United States about five times a year. […] Three sets of conjoined twins have been separated at Packard Childrens. […] On December 7, 2016 doctors successfully completed the separation of 2-year-old twins Eva and Erika Sandoval. […] Formerly conjoined twins Yurelia and Fiorella Rocha-Arias traveled from Costa Rica to Packard Childrens, where they were successfully separated. […] Conjoined twins successfully separated at Lucile Packard Childrens Hospital Stanford (2016). […] Sabuco conjoined twin toddlers successfully separated at Packard Children’s (2011).

• #1 Conjoined twins successfully separated • healthcare-in-europe.com

  https://healthcare-in-europe.com/en/news/conjoined-twins-successfully-separated.html

  Twin girls born joined at the pelvic and hip region are recovering after separation surgery at Nationwide Childrens Hospital. A surgical team of more than 30 specialists from pediatric surgery, plastic surgery, colorectal surgery, neurosurgery, anesthesiology and nursing performed the operation. This is the first time this specific type of monitoring has been done in a conjoined twins separation surgery. Tissue expansion was performed during the months prior to separation in order to ensure that there was sufficient skin to cover their wounds and to complete the reconstruction. Two neurosurgeons focused on one sister each and yet assisted each other to delicately divide their intertwined spinal cords. Imaging helped guide our understanding of the twins anatomy. Our primary concern was preservation of the twins neurologic function so they may have adequate leg movement and bowel and bladder function once separated. We are extremely pleased with the outcome of the surgery. The introduction of pre-operative 3D modeling, as well as intra-operative neurophysiological monitoring, were extremely innovative in this case. Given the breadth and depth of expertise of all of our specialists, we have the potential at Nationwide Childrens to take two patients who would never have been able to have a normal life as they were before and make them into two separate individuals who, I expect, will have healthy and normal lives. They will both need to have one additional surgery to remove their colostomies, which they have had since shortly after birth. The girls will continue to receive treatment at this time.

• #1 Mayo Clinic Health Library – Conjoined twins | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20194203

  Conjoined twins may also share one or more internal body organs. […] Though many conjoined twins are not alive when born (stillborn) or die shortly after birth, advances in surgery and technology have improved survival rates. Some surviving conjoined twins can be surgically separated. The success of surgery depends on where the twins are joined and how many and which organs are shared. It also depends on the experience and skill of the surgical team. […] Treatment of conjoined twins depends on their unique situation their health issues, where they’re joined, whether they share organs or other vital structures, and other possible complications. […] If a decision is made to separate the twins, separation surgery is usually done around 6 to 12 months after birth to allow time for planning and preparation.

• #1 Families celebrate GOSH’s Conjoined Twins Day | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/news/families-celebrate-goshs-conjoined-twins-day/

  Its impossible to list all those involved in their care, but were lucky that GOSH is one of the few places in the world that has so many skilled teams under one roof to separate conjoined twins and give them the best possible treatment. […] They were successfully separated the next day in a complex surgery. […] GOSH Charity has supported pioneering research that has helped GOSH treat more cases of conjoined twins than any other hospital in the world. […] This has included raising 300,000 to help fund innovative techniques including VR, 3D planning and printing, which has been key in helping experts at GOSH perform surgery to separate conjoined twins.

• #1 Conjoined twins separated at SJD Barcelona Children’s Hospital

  https://www.sjdhospitalbarcelona.org/en/news/conjoined-twin-girls-are-successfully-separated-sjd-barcelona-childrens-hospital

  The two girls after their operation recover with their mother on the ward at the SJD Barcelona Children’s Hospital. […] The baby girls, referred from Mauritania and treated in Barcelona through the SJD Cuidam Programme will be discharged in the coming days and will be able to return home. […] As it was impossible to separate them in their home country, Mauritanian health authorities turned to the international cooperation agreement in place between their Ministry of Health and the SJD Barcelona Children’s Hospital, referring the girls to our Catalonian facilities for assessment. […] One week after they were born, the medical team at the SJD Barcelona Children’s Hospital received photos from Mauritania, deciding that the separation was possible and could be performed at the Barcelona facility.

• #1 Yemeni Conjoined Twins Die Without Treatment Abroad

  https://www.voanews.com/a/yemeni-conjoined-twins-die-without-treatment-abroad/4780397.html

  Conjoined twin boys born in Yemen who were in urgent need of treatment abroad died Saturday, the health ministry in Houthi-controlled Yemen said overnight. […] Doctors treating 2-week-old Abd al-Khaleq and Abd al-Rahim in the capital Sanaa had said the boys could not survive in Yemen’s war-ravaged health system and needed to be taken abroad. […] A Saudi organization, the King Salman Center for Relief and Humanitarian Works, had been looking into how to get the boys abroad for treatment, Saudi state news agency SPA said Wednesday. […] In a statement carried by the Houthi-run Saba news, the health ministry said the deaths reflect the health and humanitarian situation Yemen’s children are living through as a result of the war.

• #1 Syria Feature: Urgent Treatment Needed for Conjoined Twins Near Damascus – EA WorldView

  https://eaworldview.com/2016/08/syria-feature-urgent-treatment-needed-conjoined-twins-damascus/

  Conjoined twin boys, born almost three weeks ago, are in urgent need of medical treatment near Syrias capital Damascus, according to local sources and activists. […] A doctor called me three days ago, and said we have to try to evacuate these kids. I am trying to find any avenue. The medical equipment they have is not good enough. […] However, activists are concerned that the twins need to be allowed abroad for necessary microsurgery.

• #1 Conjoined twins | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20194203/

  Recent advances in imaging before birth, critical care and anesthetic care have improved outcomes in separation surgery. After separation surgery, pediatric rehabilitation services are crucial to help the twins develop properly. Services may include physical, occupational and speech therapies and other assistance as needed. […] If separation surgery isnt possible or if you decide not to have the surgery done, your team can help you meet the medical care needs of your twins.

• #2 Conjoined Twins: Definition, Causes & Outlook

  https://my.clevelandclinic.org/health/diseases/22895-conjoined-twins

  Conjoined twins are rare. Complications can be reduced with close management from healthcare professionals. […] Successful management usually involves several medical and surgical specialists. […] The decision to attempt separation or not can bring up difficult ethical questions. […] In some cases, it’s possible to separate conjoined twins. […] The procedure to separate twins always takes extensive planning by a team of highly experienced surgeons. […] If separation surgery is attempted, only 60% of surgically separated conjoined twins survive. Healthcare providers can manage complications to improve the outlook for conjoined twins. […] Treatment of conjoined twins depends on where they’re conjoined and the extent of organ sharing. But there are surgical and medical options for many conjoined twins who survive birth.

• #2 Conjoined Twins | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/conjoined-twins

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. […] A thorough prenatal evaluation is particularly important for conjoined twins, as the location and extent of where the twins are joined and what organs are shared play a crucial role in deciding whether the twins will be separable. […] Expectant mothers visiting the Center for Fetal Diagnosis and Treatment at CHOP will undergo a full day of advanced imaging. This helps us to collect a detailed picture of the shared organs and any associated problems. Prenatal diagnosis will help identify the optimal treatment and delivery plan, and the potential for separation after birth. […] If the conjoined twins are candidates for separation surgery, CHOPs pediatric surgical team (which may include general surgeons, plastic and reconstructive surgeons, neurosurgeons, and other surgical specialties) will work with a multidisciplinary team to monitor the babies and determine the timeline and approach for the surgical procedure. […] Not all conjoined twins are candidates for separation, and the success rates for separating conjoined twins vary depending on the connection. […] Childrens Hospital of Philadelphia has successfully separated 32 pairs of conjoined twins, the first in 1957.

• #2 Families celebrate GOSH’s Conjoined Twins Day | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/news/families-celebrate-goshs-conjoined-twins-day/

  Its impossible to list all those involved in their care, but were lucky that GOSH is one of the few places in the world that has so many skilled teams under one roof to separate conjoined twins and give them the best possible treatment. […] They were successfully separated the next day in a complex surgery. […] GOSH Charity has supported pioneering research that has helped GOSH treat more cases of conjoined twins than any other hospital in the world. […] This has included raising 300,000 to help fund innovative techniques including VR, 3D planning and printing, which has been key in helping experts at GOSH perform surgery to separate conjoined twins.

• #2 Conjoined twins separated at SJD Barcelona Children’s Hospital

  https://www.sjdhospitalbarcelona.org/en/news/conjoined-twin-girls-are-successfully-separated-sjd-barcelona-childrens-hospital

  This initiative uses private donations to fund treatment for children with severe (but curable) diseases who live in low-income countries and cannot be treated there. […] The campaign to bring Khadija and Cherive was launched immediately. […] Professionals got to work immediately, carrying out various radiodiagnostic tests to confirm the degree to which the twins were conjoined, finding out which organs were shared, and if there were bone and/or blood connections between both girls. […] Testing confirmed that the twins were Omphalopagus, meaning they were joined at near the bellybutton and had two separate livers, but there was a 6 centimetre area of shared tissue. […] For very complex surgical procedures carried out at the SJD Barcelona Children’s Hospital, or for those requiring the involvement of many different professional teams (such as with separating conjoined twins), the Hospital often chooses to simulate the operation beforehand.

• #2 Conjoined Twins | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/conjoined-twins/

  Conjoined twins can be delivered by cesarean section at our state-of-the-art facility, where our team specializes in managing this condition. […] Treatment options for conjoined twins varies from case to case. The Colorado Fetal Care Center works closely with the parents to identify the best treatment plan for their babies. […] Conjoined twin treatment options vary based on where and how the babies are joined. […] Twins whose lives are immediately threatened, especially those connected at the chest or head, require emergency surgery before extensive diagnostics can be completed. […] Significant ethical considerations arise in cases where it is not possible to achieve separation without sacrificing the life or the quality of the life of one of the two twins. […] Your physicians will assess your case with a high degree of detail through multiple diagnostic tests and create a treatment plan aimed at maximizing your children’s health and quality of life.

• #2 Conjoined Twins – Seattle Children’s

  https://www.seattlechildrens.org/conditions/conjoined-twins/

  More conjoined twins survive now than in the past. This is a result of advances in imaging studies, surgical techniques and anesthesia. […] Our treatment goal is to give both children the best chance for a good quality of life. Sometimes surgery to separate the twins is the best option. The success of the separation surgery depends on many factors, mainly where the twins are connected and which structures they share. […] Sometimes separation surgery is not possible. Some conjoined twins have happy, healthy, full lives by staying connected. […] Treatment for each set of twins is unique. The connection between the twins bodies may range from fairly simple to very complex. […] Your twins healthcare team will do tests during pregnancy and after birth to learn as much as they can about your babies anatomies and how well their bodies are working. The team uses this information to create a detailed treatment plan. Our goal is to give both children the best chance for a good quality of life, whenever possible.

• #2 Conjoined Twins – Seattle Children’s

  https://www.seattlechildrens.org/conditions/conjoined-twins/

  Whether to do surgery to separate your twins depends on their chance of survival and quality of life for each baby. […] Surgery may be the best option: For the physical health of both children, while also giving them the chance to have independent bodies and lives […] Usually, twins have separation surgery in the first 3 months to 12 months of life. The success of the separation surgery depends on many factors, mainly where the twins are connected and which structures they share. […] Whether they stay connected or are separated, your twins will need long-term follow-up visits during childhood and into their early adult years. The healthcare team will check your childrens growth and development. We care for any long-term medical issues they might have. […] Seattle Childrens is one of the nations most experienced hospitals in treating conjoined twins. Care starts during pregnancy, as we monitor your twins health, learn as much as we can about their condition and plan for their care after birth. […] Our team has the knowledge, experience and facilities to: Determine which treatment is likely to give your babies the best quality of life […] Provide care for your conjoined twins if they cannot be separated or your family decides not to separate them.

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