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Doctors narrate 15-hour surgery to save conjoined twins [Video]

Doctors made an emergency decision to conduct a 15-hour complex surgery involving 38 medical experts.

Dr Evanson Kamuri speaking during a media breifing at Kenyatta National Hospital in February, 2023

Doctors from Kenyatta National Hospital and the University of Nairobi successfully separated co-joined twins in a historic 15-hour surgery, and a team of 38 medical experts.

The male infants, born four months ago in Bungoma County, were joined at the chest and abdomen and had been under observation since September of last year.

The operation was led by pediatric surgeon, Dr. Joel Lessan and was comprised of 24 surgeons, including plastic and reconstructive, pediatric surgeons, anaesthetists, and cardiothoracic specialists, as well as six nursing officers.

The twins had been diagnosed with thoracobnominocophagus, a situation where twins are joined face to face at the chest and abdomen.

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The exact cause of conjoined twins is still unknown, but it's thought that genetic factors interacting with environmental factors may contribute to their development. Another possibility is the medicines taken by the mother during pregnancy.

In this particular case, the twins shared a liver and had two hearts in one cavity, as well as shared chest bones and muscles.

According to Dr Lessan, the decision to operate on the twins came after one of them suffered a cardiac arrest, requiring a swift yet calculated move to save their lives.

Both children had multiple holes in their hearts, with one of them having an abnormal blood vessel originating from the heart.

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The twins also faced a life-threatening infection at two months that was diagnosed and treated early enough.

Despite the target time for safe separation being six months, one of the twins developed high pressure in the lungs, exposing them to even greater danger, including imminent heart failure.

This led the team to start planning for separation at just four months. Last week, the team successfully developed flaps to cover the separation lines, but after two days, one of the twins suffered a heart attack.

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An emergency decision was made to separate the twins in order to prevent further cardiac arrests.

After the successful surgery on Sunday, both infants are now under close monitoring and treatment in KNH's ICU and are progressing well.

The success of the operation has been attributed to surgical dexterity, teamwork, and dedication by the multi-disciplinary team.

Proper planning, expertise, and careful preparation of the various sub-specialities were critical factors in the success of the surgery.

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