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Conjoined twins – popularly referred to as Siamese twins – are twins joined in utero. It is a very rare phenomenon, estimated to occur in anywhere between one in 49,000 births to one in 189,000 births, with a somewhat higher incidence in Southwest Asia and Africa. Approximately half are stillborn, and an additional one-third die within 24 hours. Most live births are female, with a ratio of 3:1.
Ladan and Laleh Bijani were Iranian conjoined twin sisters. They were joined at the head and died soon after their complicated surgical separation. Coincidentally, the twins were born a century to the day after the deaths of Chang and Eng Bunker, also conjoined twins, famously known as the "original" Siamese twins.
Keith Goh is a neurosurgeon from Singapore. Goh is known for his operations in separating conjoined twins with two known successful cases and a failed attempt in separating Ladan and Laleh Bijani.
Ischiopagi comes from the Greek word ischio- meaning hip (ilium) and -pagus meaning fixed or united. It is the medical term used for conjoined twins who are united at the pelvis. The twins are classically joined with the vertebral axis at 180°. However, the most frequent cases usually structures the ischiopagus twins with two separate spines forming a lateral angle smaller than 90°. The conjoined twins usually have four arms; two, three or four legs; and typically one external genitalia and anus.
Clarence and Carl Aguirre are former conjoined twins born in Manila. They were conjoined at the top of the head and shared 8 centimeters of brain. More than 1—2 centimeters will affect brain functionality in one or both of twins. Without separation, they were expected to live around 6—8 months.
Kendra Deene Herrin and Maliyah Mae Herrin are former conjoined twins. They were separated in August 2006. They were the first set of conjoined twins to be separated to share a kidney. Kendra retained their shared kidney following the separation surgery, while Maliyah Herrin underwent dialysis until she was transplanted with a kidney donated by her mother in April 2007.
Anastasia and Tatiana Dogaru are craniopagus conjoined twins. They were scheduled to begin the first of several surgeries to separate them at Rainbow Babies and Children's Medical Center in Cleveland, Ohio. However, in August 2007 the surgery was called off as too dangerous.
Yarlagadda Nayudamma is a consultant paediatric surgeon from Guntur. Previously, he operated at the Guntur General Hospital where he was the head of the paediatric surgery department. He has performed various complex surgical procedures which have received acclamation from the scientific community and the lay public.
Sharan Shivraj Patil is an Indian philanthropist and orthopaedic surgeon.
Ascher Lawrence Mestel was an American pediatric surgeon and artist who was based in Brooklyn, New York. He was one of the pioneers in the field of pediatric surgery and was widely published. Mestel was especially well known for the groundbreaking first successful separation of Ischiopagus Tripus conjoined twins.
Wirginia June Maixner is an Australian neurosurgeon and the director of neurosurgery at the Royal Children's Hospital in Melbourne, Australia. She is known for having performed the first auditory brainstem implant on a child in Australia in 2007, and later having separated the conjoined twins, Trishna and Krishna in 2009.
Rowena Spencer was an American physician who specialized in pediatric surgery at a time when it was unusual for a female to become a surgeon. She was the first female surgical intern at the Johns Hopkins Hospital, the first female appointed to the full-time surgery staff at Louisiana State University, and the first female surgeon in Louisiana.
Re A (conjoined twins) [2001] 2 WLR 480 is a Court of Appeal decision on the separation of conjoined twins. The case raised legal and ethical dilemmas. It was ruled it would be permissible to sever and thus kill in a palliative, sympathetic manner the weaker to save the much stronger. The case was among those where it would be lawful to act—conduct surgery—against the wishes of the parents. The prevailing orthodoxy within a faith, even that of the parents, was held not to be overriding, nor general applicability of the outcome to all such cases.
Raffles Medical Group (RMG), is a private healthcare provider in Asia, operating medical facilities in thirteen cities in Singapore, China, Japan, Vietnam and Cambodia.
Abdullah bin Abdulaziz Al Rabeeah is a Saudi pediatric surgeon. He has filled a number of supervisory and advisory roles in Saudi Arabia, including Minister of Health, Advisor to the Royal Court, and Supervisor General of the international aid agency KSrelief.
Craniopagus twins are conjoined twins that are fused at the cranium. The union may occur on any portion of the cranium, but does not primarily involve either the face or the foramen magnum; their brains are usually separate, but they may share some brain tissue. Conjoined twins are genetically identical and always share the same sex. The thorax and abdomen are separate and each twin has its own umbilicus and umbilical cord.
Maria and Teresa Tapia are formerly conjoined twins born in the Dominican Republic. The twins were joined by their lower chest and abdomen and were therefore classified as omphalopagus, sharing a liver, pancreas, and a small portion of their small intestine. On November 7, 2011, the twins underwent successful separation surgery at the Children's Hospital of Richmond in Virginia.
Anthony David Holmes AO is a plastic and reconstructive surgeon who trained in both Australia and the United States, and is qualified in both countries. His primary interest is facial reconstruction and he has developed several new procedures. His most high-profile surgery was in 2009 when he worked with a large team of experts to separate the Bangladeshi conjoined twins Trishna and Krishna. In 1990 he created the Children's Craniofacial Foundation of Australia which has subsequently been renamed The Jigsaw Foundation.
James Tait Goodrich was an American neurosurgeon. He was the director of the Division of Pediatric Neurosurgery at Montefiore Health System and Professor of Clinical Neurological Surgery, Pediatrics, Plastic and Reconstructive Surgery at the Albert Einstein College of Medicine, and gained worldwide recognition for performing multiple successful separations of conjoined twins. He assisted in two craniopagus separations with Dr. Alferayan A in Riyadh, Saudi Arabia, with the first one done May 5, 2014 and the second one done February 14, 2016. Both pairs were successfully separated and are doing well.
Dr Noor ul Owase Jeelani BMed.Sci (Hons), BMBS, MRCS, MBA, MPhil, FRCS (NeuroSurg.) is a Kashmiri-British neurosurgeon and academic. He is a Consultant Paediatric Neurosurgeon at Great Ormond Street Hospital for Children (GOSH) and was the Head of the Department of Neurosurgery from 2012 until 2018. He is an Honorary Associate Professor at the Institute of Child Health, University College London. He leads the FaceValue research group in Craniofacial Morphometrics, device design, and clinical outcomes.
References
- ↑ Madzimbamuto, F D; Mbuwayesango, B; Zimunhu, T (2017). "Separation of Conjoined Twins in Harare, Zimbabwe: Case Report". East and Central African Journal of Surgery. 21 (3): 98. doi: 10.4314/ecajs.v21i3.15 . ISSN 2073-9990.
- ↑ "Nehanda Radio" . Retrieved 20 August 2014.
- ↑ "Newsday" . Retrieved 20 August 2014.
- ↑ "The Medical blog". Archived from the original on 3 May 2016. Retrieved 20 August 2014.
- ↑ Herald, The. "Zim poised for medical tourism breakthrough". The Herald. Retrieved 4 May 2021.
- ↑ "MDPCZ". Archived from the original on 1 July 2014. Retrieved 20 August 2014.
- ↑ "PubMed" . Retrieved 20 August 2014.
- ↑ "University of Zimbabwe" . Retrieved 20 August 2014.
- ↑ "Separating siamese twins in a low resource hospital Bothwell Mbuwayesango TEDxHarare". TEDx Talks. 19 February 2015. Retrieved 15 February 2017.