One-year-old twins Hussaina and Hassana Badaru will never get along together again, literally.
The twins from Kano, Nigeria, were born with a condition called pygopagus conjoining that saw them being joined at the hip with spinal cord fusion. The twins shared major organs such as the spine and spinalcord, lower gastrointestinal passage (rectum and anus) and genitalia.
That was till doctors at BLK Super Speciality Hospital separated the girls in two-part surgeries on May 25 and August 12. This was the fourth such successful separation in the world. According to surgeons, the main operation took 13-hours, followed by five more hours of reconstructive surgery.
“The most challenging part was identifying the nerves routes of both the twins. A special neuro-monitoring system was used to identify the nerve routes before separating the organs,” said Dr Prashant Jain, paediatric surgeon, who led the team.
The separation process was done in three stages. In the first stage on May 25, tissue expanders (silicon bags) were placed under the skin on the buttocks by the plastic surgery team. These were inflated once a week by pumping in saline over two months to expand the skin and generate tissue cover required for surgery.The second stage on August 12 involved separating the major organs by 40 doctors from different specialities such as pediatric surgery, pediatrics, neurosurgery, spine surgery, radiology, urology, anaesthesia, neurology and pediatrics. It was an 18-hour-long process.
“The separation of the twins was a big challenge as they had unusual sharing of alimentary canal, genitourinary system and nervous system. Rehearsals were carried out using dummies,” he said.
“The girls were colour-coded pink and blue for eight days before the surgery. All tubes, wires, catheters, leads, syringes, injections and drugs were color coded to avoid any error or miscalculation,” he said. The third and last stage, which is due after three weeks, will involve closing the temporary stool passage of both girls.Hassana and Hussaina were born on August 28, 2012 at Kano’s Murtala Muhammed Specialist Hospital. The doctors there informed the parents that one of the girls will have to be sacrificed in a separation surgery. One of them, however, referred them to Delhi.
A Kano-based philanthropist paid for the surgery as the girls’ schoolteacher father Badaru and mother Malama Badariyya Badaru could not afford it.
According to hospital authorities, the tentative cost of the surgery will come up to around $100,000. The twins will need to stay in India for three weeks for the last stage.
“We are very happy the surgery was conducted successfully and both the girls are doing well,” said father Badaru.