11 September 2007

Twins stable after separation

Fourteen-month-old Siamese twins were successfully separated on Saturday during an exhausting 16-hour operation at the Arwyp Medical Centre Private Hospital in Johannesburg.

Fourteen-month-old Siamese (conjoined) twins were successfully separated on Saturday during an exhausting 16-hour operation at the Arwyp Medical Centre Private Hospital in Kempton Park, Johannesburg.

Danielle and Danika Lowton were born on 21 June last year and were joined by the head – in medical terms known as Type A conjoined twins – facing away from each other. So even though they have literally been attached all their lives, they have never seen each other.

Conjoined twins occur only once in 2.5 million births worldwide, The Times reported.

Since birth their parents, Kribashnee and Nitesh Lowton, have only been allowed to take them home once, and they’ve been living at the Arwyp Medical Centre’s paediatric high-care ward all this time.

“The twins have been successfully separated and have survived the ordeal,” Henry du Plooy, the hospital’s spokesperson, said. “We are very grateful that they are doing well.”

Their separation is the fourth procedure of its kind in South Africa and took the efforts of six anaesthetists, four neurosurgeons, four plastic surgeons and two paediatricians.

Danielle and Dinika didn’t share any common organs and the medical team doesn’t expect any complications, said Prof Rasik Gopal, chief neurosurgeon at the Chris Hani-Baragwanath Hospital, who was part of the team that separated the twins.

“The next few days are crucial, but there was no indication that either had suffered any disability or complications,” said Gopal.

Other conjoined twins who have been separated in South Africa:

  • In 1988 Mpho and Mphoyana Mathibela from the Eastern Cape were separated at age one. However, Mphonyana died a lear later and Mpho is mentally disabled.
  • The 1994 separation of the Makwaeba twins in South Africa was not successful; both girls died from complications of the surgery.
  • In 1997 the Banda twins, Joseph and Luka, from Zambia, were successfully separated. They were separated at 11 months and are now 11 years old and in grade 4.

Why twins are sometimes conjoined
A Siamese twin originates from a genetic defect during the process of embryo formation. A defect in the doubling of genetic material leads to incomplete cell division. The result is a pair of identical twins who are joined at the hips, chest, back or head – the place where the cells didn't separate completely.

A study by the department of paediatric surgery at the Red Cross Children’s Hospital showed that almost 70 percent of Siamese twins are girls. The single biggest factor preventing separation is the sharing of a single heart.

The SA scenario In almost 74 percent of cases of Siamese twins treated and separated at the Red Cross Children’s Hospital, the children were joined front to front at their breastbone or tummy, in 19 percent they were joined back to back at the lower section of their spine, and 6 percent were joined at their hips, facing each other. Less than two percent were joined at the head.

The separation of Siamese twins involves complex surgery, and medical and ethical dilemmas. Siamese twins can consist of two equally developed babies only physically attached to each other; but sometimes consist of a dominant baby with parts of the second twin – like a baby born with 4 legs or two heads.

With medical and technological advances more Siamese twins can be saved – either both or at least one – when separated.

- Health24, September 2007

The Times - September 9, 2007
Sapa – September, 9 2007


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