Operatie om Siamese tweeling Iran te scheiden begonnen

[Simon]

Operatie om Siamese tweeling Iran te scheiden begonnen

Uitgegeven: 6 juli 2003 10:10
Laatst gewijzigd: 6 juli 2003 10:10

SINGAPORE - In Singapore is zondag de operatie begonnen om een volwassen Siamese tweeling van elkaar te scheiden. De 29-jarige zussen uit Iran, Laleh en Ladan Bijani, zijn met hun hoofden aan elkaar verbonden. De operatie brengt grote risico's met zich mee. Een of beide vrouwen kunnen overlijden en er is kans op blijvende lichamelijke en geestelijke handicaps.

Laleh en Ladan maakten zondag een opgewekte indruk, toen zij naar de operatiekamer werden gereden, zo berichtten bronnen in het Raffles ziekenhuis in Singpore. De afgelopen maanden zijn zij uitgebreid onderzocht en hebben ze tientallen test ondergaan.

Zaterdag ontdekten artsen nog dat de bloeddruk in hun hoofden twee keer zo hoog was als bij 'normale' mensen, waardoor een operatie niet alleen 'cosmetisch', maar ook medisch noodzakelijk is.

Gevaarlijk

De vrouwen zijn eerder door specialisten in Duitsland afgewezen als patiënt, omdat de ingreep te gevaarlijk zou zijn. Laleh en Ladan, beiden afgestudeerd als jurist, hebben apart functionerende hersenen, maar delen onder meer een belangrijk bloedvat.

Alle eerdere operaties van Siamese tweelingen die met het hoofd aan elkaar vast zaten, werden uitgevoerd op baby's. De neurochirurg die de operatie leidt, Keith Goh, voerde een dergelijke ingreep in april 2001 uit op een 11 maanden oude Nepalese tweeling.

De operatie van de zussen Bijani duurt naar verwachting 28 uur. Goh wordt onder anderen bijgestaan door een plastisch chirurg en een kinder-neurochirurg.

[Joesoef]

Ladan
Kuala Lumpur, July 4, IRNA -- A large number of Iranian citizens
residing in Singapore have volunteered to donate blood that might
be needed during the historic separation surgery of the Iranian
conjoined twins, Laleh and Ladan.
Singapore's National Blood Transfusion Center announced
here on Friday that following a request made for blood donation to
help the Iranian conjoined twins that are attached to each other at
the skull, during their separation surgery --Operation Hope--, a
large number of Iranians residing in Singapore have volunteered for
the purpose.
Speaking to the reporters on Friday, a spokesman for Singapore's
Blood Transfusion Center said, "Our center was directed by Raffles
Hospital authorities to ask for blood donation for the purpose, and
our request in that regard was received warmly, particularly by the
Iranians living in this country."
The 29-year-old conjoined twins - fused at their heads - have
made the world sit up and take notice by defying doctors' warnings
about the risks of surgery and remaining very firm about their desire
for separation.
The operation will be carried out at Singapore's Raffles Hospital
and neurosurgeon Dr Keith Goh will lead the 25-member operation team
from Singapore, the United States, Japan, Nepal, France and
Switzerland.
There will be up to 48 hours of actual surgery and Laleh and Ladan
will be in a seated position for the operation. The law graduates have
undergone intensive counselling about the risks of surgery, while
during their seven-month stay in Singapore they have remained adamant
to have the operation done.
"As we anxiously wait for our surgery ..., we have been praying
every day for our operation. We are excited about it, as we've waited
29 years for it," they said in a letter, published recently.
"Both of us have started on this journey together and we hope that
the operation will finally bring us to the end of this difficult path
and we will begin our new and wonderful lives as two separate
persons," they added.
The Siamese twins were turned away in 1996 by German doctors who
thought the operation was too risky. Their doctors, however, believe
in the success of the operation since they have anatomically intact
and individual brains.
The downsides are related to the fact that Laleh and Ladan have a
shared major vein and their brains, though fortunately lying side by
side, are contained in a single skull case.
Moreover, the problems are different from the usual medical issues
of life and death. Doctors are worried about consequences,
complications, and the high risk of death or severe disability after
the surgery.
They have also to consider whether the twins can handle the
operation psychologically and cope with being separated from someone
they have been with for the last 28 years.
Doctors at Ruffles Hospital have come to terms with all these
questions, besides securing approval of Medical Ethics Committee
which deals with the ethical question of high risk surgery when life
is not at risk.
Singapore doctors performed the operation in 2001 on infant girls
from Nepal, but experts say an operation on adults is unprecedented.
The functional anatomy of adult brains, they say, is different
from infant brains, in which personality is still underdeveloped
and the ability to recover is better.
Against these odds, doctors are working on the promise that both
twins should have an equal chance of survival and have the adult
sisters' dreams come true: Ladan wants to be a lawyer and Laleh likes
to be a journalist.
There will be three stages in surgery: radiological test,
neurosurgical separation of conjoined brains and reconstruction of
the skin and soft tissues on the exposed area of their heads. The
separated twins, doctors say, may have to to go a long period of
rehabilitation.
Raffles Hospital has underwritten the twins' stay at the hospital
as well as the previous costs of tests. Doctors will also waive their
professional fees for the surgery.
However, it is estimated that the costs of separation surgery and
postoperative care will amount to 500,000 US dollars and Raffles
Hospital has set up the Medical Samaritan Fund to raise funds for the
surgery.
Lending his experience and skill in separation surgery is the
world's renowned neurosurgeon Dr Benjamin Carson, director of
pediatrics neurosurgery at the John Hopkins Medical Institutions in
Baltimore.
Carson successfully separated a pair of craniopagus twins in
Germany in 1987. In 1997, he led a team of South African doctors in
the first successful separation of vertical conjoined twins.
NA/JB
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