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Mulago Medics Separate Conjoined Twins

Dr Philis Khisa says the scoping process started last week to identify the exact organs that the children shared.
The separated Co-joined twins. Their mother Brenda Ajok says she never attended antenatal clinic and just showed to deliver at Bala Health Center in Kole district.

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A team of 20 specialists at Mulago National Specialized hospital have successfully separated 11 months old Siamese twins.

Dr Philis Khisa, one of the doctors involved in the operation said that the process started last week with an investigation technically known as scoping where they had to identify the exact organs that the twins shared. They found that while the vaginal opening was one, inside they had separate organs. Also, they found that the twins were conjoined at the pelvis, at the large bone called the sacrum.

Dr John Sekabira, a consultant paediatric surgeon who led the team told journalists this afternoon that the Siamese twins’ rectum was fused at the end, they didn’t have a separate vagina, shared a urethra and the spinal code was joined at the tail end.

 

//Cue in; “The rectum we…

Cue out… the tail end”. // 

The operation that started at Midday on Monday ended at 9:00 am but doctors who conducted the surgery refer to it as one of the most complicated procedures which have to be done slowly and carefully since it also separating blood vessels.

//Cue in; “Immediately we got…

Cue out…bone called the sacrum.”//

Separation of the babies didn’t happen until 4 a.m, Dr Khisa says, adding that this is a major milestone as the children had been kept under monitoring since December 21 when they were referred from Lira hospital three days after birth through a Caesarean Section operation. 

However, during the lockdown in April, the couple requested to go back home with a halt in non –emergency health services. “Unfortunately the children got malnourished. The parents could not afford proper feeding so we had to treat this before embarking on this operation”.  

In September, they start the early processes with plastic surgeons putting on them tissue expanders which would this morning be used to cover the defect. They worked in teams of vascular surgeons, neurosurgeons and pediatric surgeons among others. 

//Cue in; “surgery started at ….. 

Cue out…you come back.”//

Sekabira says the babies are to remain admitted in the hospital for six months to one year as they await another surgery to correct other tissues like the reproductive system such that each can live healthily on their own.

However, conjoined twins especially in African countries like Uganda rarely survive and when they survive usually they don’t survive the surgery.  Uganda’s first conjoined twins to survive were operated on seven years ago in a surgery that was conducted in Egypt.

Dr Byarugaba Baterana, the hospital director says the earlier operation was conducted by Ugandan doctors who travelled abroad because the country didn’t have the necessary equipment for the operation which can go for the highs of 10,000 dollars in countries like India and much higher in the West.

The operation which is also the first to be conducted at the new super-specialized theatre facility has been conducted at a free charge in Mulago in their test running initiative before fully opening for other tertiary operations like organ transplants.

Annually, three to four Siamese twins are referred to Mulago hospital but many times they only have to do emergency operations. For instance, recently Dr Sekabira says they had to conduct an operation on twins where one had died.  The other twin didn’t survive the operation either.