Brazil's Rare Conjoined Twins Separation Surgery Was Successful, Here's What You Need To Know About Conjoined Twins

Siamese Twins Illustration (Istockphoto)

JAKARTA - Brazilian conjoined twins Arthur and Bernardo Lima have been successfully separated through surgery using virtual reality technology. Both are Craniopagus twins who have one skull.

Arthur and Bernardo were born in 2018 and have been together for almost four years. The separation operation has been performed at least nine times. According to local doctors, this is the most challenging and risky separation because the two share several vital blood vessels. In the end, the tenth operation which took 27 hours and involved 100 experts managed to separate the two.

Reported by VOI from the Mayo Clinic, Tuesday, August 2, conjoined twins are two babies who are born physically connected to each other. Conjoined twins occur due to incomplete division of the embryo to form two individuals. Although two fetuses will develop from this embryo, they will remain physically connected. In addition, they may also share one or more internal organs.

Siamese Twins Sketch (image: Comons Wikimedia)

Conjoined twins have the potential to die while still in the womb or die shortly after birth. However, the survival rate of conjoined twins is now increasing thanks to advances in technology and medicine. Some of the surviving conjoined twins can be separated through a surgical procedure. The success of the operation depends on the type of conjoined twins, how much they share organs, and the experience and skills of the surgical team.

According to Alodokter, conjoined twins are divided into several types based on the organs or body parts that are connected to each other, namely:

Thoracopagus

Conjoined twins occur when the baby's chests stick together. This is a common case of conjoined twins. Generally, they have only one heart, one liver, and one intestine.

Omphalopagus

Omphalopagus are conjoined stomach twins attached. They have only one liver, one lower small intestine, and one large intestine.

Pygopagus

Conjoined twins occur when the baby's lower back and buttocks are pressed together. Generally, they have only one digestive tract, one genitalia, and one urinary organ.

Craniopagus

Craniopagus conjoined twins occur when the baby's head is pressed against the side or the top of the head. Generally, they have one skull, but different brains. Arthur and Bernardo Lima are Craniopagus conjoined twins and were successfully separated.

ischiopagus

Conjoined twins occur when the baby's pelvis sticks together. Babies with Ischiopagus conjoined twins will face each other or back to back.

Parapagus

Parapagus is a type of conjoined twins that occurs when the baby's pelvis, abdomen, and chest are attached to each other in a sideways position.

Cephalopagus

Conjoined twins occur when the baby's faces stick together. Generally, their faces are on opposite sides and have only one brain. Babies who experience this condition are very difficult to survive.

Rachipagus

Conjoined twins occur when the two babies' spines stick together. This is a very rare case of conjoined twins.

Pregnancy with conjoined twins can increase the risk of serious complications. Conjoined twins require a surgical delivery by caesarean section (C-section) because of their anatomy. Conjoined twins tend to be born prematurely with a very high risk of dying one or both babies. Respiratory problems and heart problems are more likely to befall conjoined twins shortly after birth. In later life, they will not escape from diseases such as scoliosis, cerebral palsy, or learning disorders.

Rehabilitation and follow-up care need to be done to train the abilities of each baby, if the separation surgery is successful. This treatment can be done through physical therapy, communication, and social. This is so that both babies can carry out normal activities like babies in general.

If separation surgery is not possible, for example because both babies only have one heart or the baby's parents don't want their child to be operated on, the doctor will plan further medical care to ensure the health of the conjoined twins.

Pregnancy with conjoined twins cannot be prevented because the causes and risk factors are not known for certain. The best thing that can be done is to carry out routine pregnancy check-ups to monitor the health of the mother and fetus. That way, the possibility of complications can be immediately identified, including if you are pregnant with conjoined twins.