Twins conjoined at the head: First of its kind surgery in India

Twin boys conjoined at the head have undergone surgery in an attempt at separating them. The surgery is the first of its kind in India.

Due to the twins’ skulls being joined, the surgery has presented itself as a particularly complex, highly intricate procedure. Adding to the complication the twins shared veins which returned blood from the brain to the heart, meaning blood vessels would need to be rerouted during the surgery.

The 28-month-olds, named Jaga and Baliya, are from Milipada village of Kandhamal district of Odisha. They were sent to the All India Institute of Medical Science (AIIMS) in New Delhi on July 13th after a large amount of media attention convinced the state government to intervene and provide funding for their treatment. Chief Minister Naveen Patnaik sanctioned  Rs 1 crore from the CM’s Relief Fund for the funding of the surgery on the conjoined twins.

The team involved with the operation is both large and multi-disciplined. It incorporates twenty specialists, including neurosurgeons, neuro-anaesthetists and plastic surgeons, as well as a Japanese expert in this kind of procedure flown in to aid the team.

Before the operation, multiple MRI scans, CT scans and angiograms were conducted on the brains of the two children to assess the extent to which veins were shared. This was then used to plan a course of action during the surgery to give the best chance of success.

The first phase of the surgery has so far been successful. Surgery started at around 9 am on Monday August 28th and went on till 4.45 am on Tuesday. The twin’s brains have been partially separated. They are currently on a ventilator and under constant medical supervision to determine how well they have responded to this part of the surgery. They have been moved to the hospital’s general ward.

The planned procedure will involve a second and final phase of the operation, to take place in October to November. Originally planned to start in mid-October, the second stage has been postponed due to shortages of blood. Nonetheless, these phases are hoped to result in the full separation of the twins. Doctors, however, have indicated that any optimism should be tempered with caution. Only around fifty surgeries have been performed on twins joined at the head, the survival rate is low, only a few surviving the procedure.

The parents of the twins are poor farmers, and have expressed gratitude to the state government. Bhuiyan Kanhar, the twin’s father, told AIIMS doctors, “We are thankful that our state government came forward to help. They arranged for the transportation and other costs involved for treatment at AIIMS,”