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UK surgeons separate twin girls joined at head

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Published : Sept. 19, 2011 - 11:01

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 LONDON (AP) _ Sudanese twins born with the tops of their heads joined together have been separated in a rare and risky series of operations at a London children‘s hospital, officials said Sunday.

Facing the World, a charity which helps disfigured children, said it had helped fund the four-stage operation on 11-month-olds Rital and Ritag Gaboura.

Twins born joined at the head are known as craniopagus twins and they occur in about one in 2.5 million births. Separating them can be dangerous, especially if _ as in this case _ there’s significant blood flow between their brains.

Undated handout photo released Sunday Sept.18, 2011 by British charity Facing the World of conjoined twins Rital and Ritag Gaboura (left to right not given) before they were successfully separated at London‘s Great Ormond Street Hospital for Children. (AP) Undated handout photo released Sunday Sept.18, 2011 by British charity Facing the World of conjoined twins Rital and Ritag Gaboura (left to right not given) before they were successfully separated at London‘s Great Ormond Street Hospital for Children. (AP)


``It‘s extremely high-risk,’‘ said Dr. James Goodrich, who coordinated a similar separation of conjoined twins at New York’s Montefiore Children‘s Hospital in 2004.

But the alternative can be just as bad. Because conjoined twins almost never pump the blood across their bodies evenly, the strongest sibling strains his or her heart trying to pick up the slack. Facing the World said that Ritag’s overworked heart was already failing by the time her family arrived in Britain.

The charity said that the separation took place in stages at London‘s Great Ormond Street Hospital. Two operations took place in May. Tissue expanders _ essentially balloons intended to help stretch the babies’ skin over their newly exposed heads _ were inserted in July. The final separation took place on Aug. 15.

``Incidences of surviving twins with this condition is extremely rare,‘’ lead surgeon David Dunaway said in a statement released by the charity. ``The task presented innumerable challenges and we were all very aware of our responsibilities to the family and these two little girls.‘’

The charity released before and after photographs of the twins. The before photo showed the two sprawled out on a bed, with their heads joined just above the hairline to form what appeared to be a single, solid unit. The after photograph showed both side-by-side looking alert and healthy, clutching white stuffed animals.

Although rare, operations to separate twins linked by their heads aren‘t unheard of. The U.S. National Library of Medicine records that one of the first successful operations to separate craniopagus twins took place in 1956.

In 2003, surgeons in Dallas separated 2-year-old Egyptian twins joined at the head, and a year later Goodrich was one of a team of doctors which separated Filipino twins in four major surgeries that took place over 10 months.

Even successful operations can leave neurological damage, although that didn’t immediately appear to be the case with Rital and Ritag.

``Within days the twins were back on the general ward interacting and playing as before,‘’ the charity said. Its executive coordinator, Sarah Driver-Jowitt, predicted that the girls‘ parents _ who haven’t been named _ may soon return home ``with two healthy, separate girls.‘’

Goodrich agreed.

``So far the results have been exceptional,‘’ he said. ``I think both kids will do quite well.‘’

<한글기사>

英서 머리 붙은 샴쌍둥이 분리수술 성공





(런던 로이터·AP=연합뉴스) 영국 의료진이 머리가 붙은 샴쌍둥이의 분리수술에 성공했다고 이 수술을 후원한 자선단체 ‘페이싱 더 월드’(Facing the World)‘가  18 일 밝혔다.

이 단체에 따르면 다음 주 돌을 앞둔 수단 출신의 리탈과 리타그 개버라 자매는 태어날 때부터 머리가 붙은 ’두개 결합체‘ 쌍둥이로, 넉 달에 걸쳐 4번의 대수술 끝 에 새 삶을 살게 됐다.

정수리 부분이 하나로 연결된 두개 결합체 쌍둥이는 전 세계 출산 250만 건 중 한 건 비율로 일어나는 매우 희귀한 경우며 분리수술이 성공할 확률도 매우 낮다.

수술에 참여한 의사들에 따르면 리타그가 언니 뇌의 반에 혈액을 공급하고 있었 고 공급된 피 대부분은 다시 리타그의 심장으로 흘러가고 있었다. 따라서 수술할 경 우 뇌압이 급격히 저하해 신경 손상을 초래할 수 있어 매우 위험한 상황이었다.

수술을 주도한 그레이트 오먼드 스트리트 병원의 외과의 데이비드 더너웨이는 “

이런 조건을 가진 쌍둥이기 살아나는 경우는 매우 드문 일”이라고 말했다.

쌍둥이는 지난 5월 두 차례 수술을 받은 데 이어 7월에 조직확장술을, 그리고 지난달 15일에는 나머지 수술을 최종적으로 받았다.

분리수술은 성공적으로 이뤄져 현재 쌍둥이가 어떠한 신경계의 부작용도 겪지 않는 것 같다고 의료진은 말했다.

개버라 자매는 작년 9월 수단의 수도 하르툼에서 의사 부모 밑에서 태어났으며 쌍둥이 부모는 자선단체에 분리수술 후원을 요청했고, 지난 4월 런던으로 건너왔다.

자선단체 측은 “며칠 내 쌍둥이들이 일반병동으로 옮겨 전처럼 놀 수 있을 것”이라고 말했다.