Siamese twins, separated in Israel last month, leave hospital

One-year-old twins who had been attached on the back of their heads and who had been separated by a team of doctors from Soroka University Medical Center in Beersheba, returned home.

The girls underwent rare surgery – some have described it as near miraculous – last month. They were released on Thursday but will continue to receive outpatient treatment in hospital.

Both have been undergoing local and international assessment and treatment since their birth in August 2020.

“There is a tremendous sense of satisfaction for everyone who was involved in the process,” said Dr. Mickey Gideon, director of pediatric neurosurgery at Soroka. “We accompanied the twins during the mother’s pregnancy, before the operation and the last month in the hospital in the pediatric intensive care unit, then in the pediatric surgery unit and we will be there for them long afterward.

The procedure that children have undergone is extremely rare – it has only been performed around 20 times around the world so far. They were the first Siamese twins in Israel to have the operation and were also among the youngest in the world to have the operation.

One of the twins during physiotherapy at the Soroka Child Development Institute (credit: courtesy)

According to a study published by UC Davis Health at the University of California last year, craniopagus twins occur in about one in 2.5 million births.

The 12-hour procedure involved dozens of medical staff, many of whom have been supporting parents since the birth of their daughters. This included neurosurgery, plastic surgery, pediatric anesthesia, pediatric intensive care, and brain imaging specialists.

The doctors used advanced equipment and technology, some of which had to be brought to the hospital specifically for the procedure. This included 3D modeling, virtual reality, and special surveillance devices.

Specifically, they used STRATASYS, 3D4OP 3D models based on MRI, CT and angiography images that simulated the complexity of the connection between blood vessels, meninges, skull bones and skin of the twins. .

Using the VR model called Surgical Theater, the team was able to simulate the procedure and plan it in the most precise way. Dozens of simulations of all stages of the operation were performed in each model before the day of surgery.

During the operation, after the separation of the blood vessels was successful, the bones were separated. The doctors then split into two teams to work in parallel in two separate operating theaters, reconstructing the skull of each of the girls and closing the skin.

After the operation, the twins were hospitalized for about a month, Gideon explained, as they recovered without complications.

They also received physiotherapy treatments to close their motor gap because until surgery they couldn’t roll over on their stomachs or sit down because they were Siamese.

“Today they are already turning around and the more dominant twin has even started to sit up,” Gideon said. “Girls are expected to continue the intensive rehabilitation process even after their release. “

In the future, he said they might need more operations, most likely cosmetic surgeries on the skull structure.

“Today is particularly exciting for me,” said Gideon. “Beyond a professional milestone in the planning, execution and implementation of an operation on a scale never seen before in Israel… I have been associated with twins of a extraordinary way. Understanding that this complex process significantly affects their future strengthens me and all the teams involved.

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