- A rare and complex surgery to separate conjoined twins recently took place in Italy
- The twins are from the Central African Republic and recently turned two
- Surgeons involved in their operation say their motor and cognitive development should be normal
In an incredibly rare surgery that involved an equally rare congenital abnormality, two-year-old twin girls, Ervina and Prefina Bangalo, from Mbaiki, Central African Republic, had their skulls separated by doctors and nurses from the Bambino Gesù Paediatric Hospital in Italy, CNN reported this month.
According to a press release from the hospital, the separation occurred on 5 June and the girls are expected to make a full recovery. Although there are no official numbers for how often this occurs, one study estimates craniopagus conjoined (joined at the head) twins are born once in every 2.5 million births, with around 40% being stillborn. The girls also shared a majority of blood vessels, making the success of the operation that much more remarkable.
This is also the first report of a successful intervention documented in medical literature.
How the twins ended up being operated on by Italian surgeons
Hospital president Mariella Enoc met the twins on a trip to the Central African Republic in July 2018, and offered to treat them in Rome. They arrived with their mother, Ermine, in Italy in September 2018 and had their first stage of treatment in May the following year.
A second phase of treatment took place in June last year, with their third and final surgery last month. The team described this as "one of the rarest and most complex forms of fusion".
"It was an exciting moment, a fantastic, unrepeatable experience," said Carlo Marras, head of neurosurgery at the hospital.
"It was a very ambitious goal and we did everything to achieve it, with passion, optimism and joy."
Normal development expected
The surgery’s impressive outcome meant that the girls’ brains are intact and, according to the hospital, their motor and cognitive development should be normal. The hospital has since released a video showing the girls celebrating their birthday with their mother and healthcare staff singing the traditional happy birthday song to them in Italian, while unwrapping their gifts.
Similar case around this time last year
Safa and Marwa, also born joined at the skull and from Pakistan, were separated by doctors at Great Ormond Street Hospital in England last year. The BBC covered their journey requiring multiple surgeries and many hours of work by hundreds of hospital workers.
“These cases are incredibly rare. A portion of each twin’s brain is being supplied by the other twin and we’ve not had this before. We need to untwist the brains,” said Dr Owase Jeelani, a paediatric neurosurgeon, while Professor David Dunaway, a plastic and reconstructive surgeon also involved in the surgeries described it as an “absolute marathon”.
Virtual reality and 3D models assisted the surgeons to prepare for the operation, which also turned out successfully. Although they will face some challenges during their progress, Dunaway said that, overall, it’s a positive outcome for them and they have a chance of leading a happy life.
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