Twin girls, born conjoined at the back of the head, saw each other for the first time after successful and rare surgery to separate them in Israel.
The 12-month-old girls were separated on Thursday after a 12-hour operation at the Soroka University Medical Center in Beer Sheva, the hospital said Sunday. It was the first time that surgery to separate conjoined twins had been performed in Israel.
“Whenever you have two babies attached together with their brains and the vessels supplying the brains, it makes it even more complex and impossible for us neurosurgeons to expect and to know how to deal with it,” Mickey Gideon, director of pediatric neurosurgery at Soroka Medical Center who led the surgery, told NBC News.
He estimated that similar surgeries had only been performed 20 times around the world.
The girls, whose names have not yet been released, were among the youngest twins ever to be separated. Gideon had wanted to perform the surgery before the age of 1, an important developmental year, he said.
“They are recovering well, and they are neurologically ok,” he said in a telephone interview. “Cognitively we can’t estimate yet. We have to wait and examine them and see what happens.”
The girls are now alert, conscious and crying and have their heads bandaged. In the days following the surgery they were separated from each other to receive care and were placed in the same crib for the first time on Sunday.
“The first two days after the operation we saw that they were a little agitated, and when we put them together it was a wonderful moment to see how they became calm and quiet,” said Gideon. “For the first time they were looking at each other after being attached at the back of their head.”
Gideon and his team started planning the separation surgery while the twins were still in utero. Then, after their birth at 34 weeks last August, doctors tested and examined them repeatedly to get a more detailed and precise understanding of their brains and bodies. They also worked closely with several high-tech companies, developing 3D models and using virtual reality simulations to prepare for the surgery so everyone involved knew exactly what to do during each part of the surgery.
To make it possible to close the scalps of the two girls after the separation, the babies had skin and tissue expanders inserted in their heads several months ago.
During the operation, after doctors separated their blood vessels and bone, they split into two teams in two separate operating rooms to reconstruct the skulls and scalps of each baby.
A team of 50 was involved in the planning and surgery, and the local medical team worked closely with Gemini Untwined, a charity that offers expertise on separating twins conjoined at the head, and doctors Noor ul Owase Jeelani, a pediatric neurosurgeon at Great Ormond Street Hospital in London, and David Staffenberg, a plastic surgery specialist from NYU Langone in the U.S., who have performed similar surgeries.
Specialists in anesthesia, pediatric intensive care, and brain imaging also took part in the complex surgery, along with nursing teams, pharmacists, laboratory staff, and social workers.