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January 31, 2015 / 11 Shevat, 5775
 
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Rare Conjoined Twins Separated at Rambam Hospital

The surgery was a complete success, but the surviving twin is still not out of danger.
Conjoined Twins

In a complex surgery – the first of its kind in Israel – conjoined twins were separated at Rambam Medical Center. One twin was stillborn; the second is fighting for his life. For what appears to be the first time in Israel, Haifa’s Rambam Medical Center separated an incredibly rare type of conjoined twins last week. One twin had not fully developed and was fused into his brother’s body. The surviving twin, who is in severe condition and fighting for his life had, in addition to his own head, arms, and legs, another pelvis, legs, arms, kidney, and digestive system.

There have only been 150 documented cases of similarly conjoined twins in the last 126 years, since the first case was been documented in the 16th century. It appears to be the first time this surgery has ever been attempted in Israel.

In order for the surgeons to be able to perform this delicate operation, they needed to understand which organs are shared, in order to protect the life and health of the surviving twin. His condition was life-threatening, both because of this rare occurrence, and because of an accompanying heart defect.

Everyone worked together to perform this historical surgery. The doctors at Rambam performed a CT scan to try and determine the complicated internal anatomy. Having never come across a similar situation, everyone – from cardiologists to heart surgeons, urologists, orthopedists, plastic surgeons, anesthesiologists, pediatric surgeons, and more – met and planned this complicated procedure. The surgery then took place, with the complete cooperation of surgeons from many different fields. A few of the many doctors to participate were Dr. Ran Steinberg, Head of Pediatric Surgery; Dr. Arcady Vachyan, Head of the Pediatric Laparoscopic Surgery Unit; Dr. Dana Egozi, Senior Plastic Surgeon and Head of the Burns Unit; Dr. Ayman Bukaii, anesthesiologist, and others. During the course of the surgery, which lasted four hours, all the deceased twin’s organs were separated from the surviving twin. The only organ which they had shared completely – the liver – was left whole in the surviving twin.

According to Dr. Steinberg, who headed the surgery, the surgery was a complete success, but the surviving twin is still not out of danger. “This kind of surgery is incredibly complicated, with low survival rates,” said Dr. Steinberg. “In many cases, as here, the twin also suffers from accompanying heart defects, which further endangers the infant’s life.”

The surviving twin is still hospitalized in Rambam’s Neonatal Intensive Care Unit. His condition is severe, but stable, and doctors continue to fight for his life.

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