Saturday, 7 September 2013

For conjoined Nigerian twins, life begins afresh

FOR the Nigerian parents of conjoined twins, Hussaina and Hassana Badaru, watching their daughters celebrate their first birthday together after a successful separation surgery is nothing short of a miracle – and they have a team of Indian doctors to thank for it.

Experts in Nigeria had given up hope of saving both the girls in case of separation surgery that was needed to give them a normal life.
The twins shared their spinal cords, lower intestinal tract and genitourinary tracts. This meant that they had one common passage for faecal matter and another one for passing urine.
Their parents got to know about such surgeries being successfully carried out in India. The twins were seven months old when they were taken to the BLK SSH hospital, India.
“Separation of the Badaru twins was a big challenge as they had unusual sharing of alimentary canal, genitourinary system and nervous system. Rehearsals were carried out using dummies. Every surgical step was defined and rehearsed over and over again till it reached precision,” said Dr Prashant Jain, Consultant, Paediatric Surgery.
Badaru twins’ case was a miracle because success rate in such cases is said to be just 30 per cent.
According to information gathered from indiatvnews.com, a team involving 10 super specialities was formed to do the separation in three stages. The surgery lasted for about 13 hours after which the girls were moved to separate OTs to carry out further reconstruction.
“In the first stage, tissue expanders were placed to get adequate skin for covering the wounds after separation. Tissue expanders are essentially silicon bags which are gradually inflated with saline placed under the skin on the buttocks.
“By pumping in saline over a period of two months, the tissue expanders were gradually inflated once a week. This helped in expansion of the skin and generation of good tissue cover,” Jain said.
This was followed by the actual separation of the spinal cords, intestine and genitourinary tract, which was carried out along with the reconstruction.
In the same stage, a temporary passage for faecal matter was created in the sisters’ abdomen which will be closed after two months.
“The girls were colour-coded (one pink and the other blue) for eight days before the surgery so that there would be no error at all. All tubes, wires, catheters, leads, syringes, injections and drugs were also colour-coded in accordance with the pink or blue code to avoid any error or miscalculation,” he said.
Dr A K Bath, Plastic and Reconstructive Surgeon, constructed a new genitourinary tract with new genitalia for each of the girls. Their intestines were repaired with separate anal openings.
“It took five hours of nerve-wracking work, but now the girls will appear absolutely normal externally as well,” said Bath.
Both the siblings are now stable and have shown no signs of any neurological deficit.
However, heraldsun.com.au reports that a team of 40 specialists performed the “nerve-wracking” 18-hour surgery last month at a New Delhi hospital.
Sporting matching bright pink dresses, the one-year-old girls sat patiently on their parents’ laps as doctors explained the surgery.
“They were fused at their back when they came to us, which is very rare,” paediatric surgeon, Prashant Jain, said.
“Usually, the twins are joined in the head or the upper body. It posed a huge challenge to our team of doctors,” Dr Jain said.
Doctors held the media conference as the twins, Hussaina and Hassana, sat happily, grabbing at a mobile phone, clutching a rattle and trying to pull off their mother’s earrings.
Malama Badariyya Badaru, the mother of the twins, said she was overjoyed at finally being able to hold the girls in her arms “individually.”
The girls, sporting hair bands of different colours to make recognition easier, looked curiously at the cameras during the conference at the BLK Super Speciality hospital.
Dr Jain said only 15 per cent of all conjoined twins are born with this type of condition, known medically as pygopagus. Medical literature lists just 32 such cases, he said.
The family, from Kano State, were told by doctors in Nigeria that one of the girls may not survive if they went ahead with the surgery in Nigeria.
An unnamed philanthropist then stepped in to help, and suggested they travel to India which offered good facilities at relatively low medical costs, Dr Jain said.

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