The Conjoined twins, three day old now
Rwanda’s medical specialists have said that they are working round the clock to ensure that conjoined twins born at the Kigali Teaching University Hospital (CHUK) this Thursday September 15, 2023 are ready for separation.
Dr. Edmond Ntaganda the lead pediatric surgeon at CHUK revealed that the Siamese twins are conjoined at the lower chest (abdomen) and at the pelvis level, and have been given an emergency procedure (Pygopagus) to enable them pass their stool.
Siamese twins, also known as conjoined twins, are identical twins who are physically connected to each other at birth. This occurs due to the incomplete division of their bodies.
On the global level, such twins are separated within hours or days of undergoing intensive surgical procedures and science shows that the separation can be complicated.
Data shows that when one of the conjoined twins dies, usually the surviving twin follows in that twin’s footsteps, whether from natural causes or an unintended catastrophe, however once conjoined twins are split apart the chances of surviving are limited (1/5000) though some live for some good years.
For example, Lori and George Schappell, born Lori and Dori Schappell in 1961 and alive till today are probably the most interesting conjoined twins alive who say they live “very normal lives”, which they have had to fight for.
CHUK Hospital Director General, Lt Col Dr. Tharcisse Mpunga told Kigali Today website that in this new case the operation will be done after a period of between six months and one year.
Mpunga explained that Rwanda has local surgery specialists and visiting surgeons who can conduct the operation but first of all the twins in question need to gain some body weight, and have concrete body parts.
“It is important to wait for six months or probably one year when the babies gain some weight and all the organs take fair shape, to make sure that nothing is left out in the surgery process,” Mpunga told Kigali Today journalist.
He also said that twins will most probably be separated at the new surgical facility in Masaka Hospital but if there is need to transfer the twins to be operated abroad this can also happen.
“A local team, joined by some visiting doctors will handle the case, but we can refer the twins to a foreign hospital if need be,” Mpunga said.
In Rwanda the first separation surgery for conjoined twins was conducted at CHUK on female pygopagus twins (joined back to back) three months after birth. Following this case, in 2018 a team of doctors from King Faisal Hospital separated seven month old conjoined twin girls.
For both babies a posterior sagittal anorectoplasty was performed with derivate ileostomy without problem. No complications occurred during the operation, oral feedings were done on the third postoperative day.
Ileostomy closure was done three weeks after and babies were discharged from the neonatal unit at 35th postoperative day.
The East and Central African Journal of Surgery Vol. 18 No. 1 (2013) shows that adequate preoperative investigation with a well-organized and trained team contributed a lot to the success of conjoined twins’ separation.
Currently the twins in latest case are under intensive care at CHUK and the hospital administration says that it will take care of the children and their parents who will stay around until the discharge of the twin babies.
