IN a marathon operation, a team of surgeons at Cape Town’s Red
Cross Hospital have successfully separated a pair of Siamese twins
from the Eastern Cape, four-month-old girls born joined at the
pelvis.
The girls, Zinzi and Zanele Kona, were born in Port Elizabeth’s
provincial hospital on November 27 last year, and have been cared
for at Red Cross since then.
The operation, involving 14 specialists, began at 7.45am on
Wednesday, and the last twin, Zinzi, was wheeled out of the
operating theatre and into intensive care at 3.20am.
”I think it went very well,” said Prof Alastair Millar, who led
the surgical team in the complex operation. ”We weren’t really
surprised by any of the findings…. We planned the operation step
by step and it went according to plan.”
The girls were physically separated at 9.22pm on Wednesday, and
reconstructive surgery took another five hours.
”It’s very complex because so many functional parts of the body
are involved. Once they are separated from each other it leaves a
huge wound which has to be closed,” said Millar.
The twins were born with legs splayed out at a 180-degree angle
and fused spines. However neurosurgeons discovered during the
operation that their spinal cords were merely touching, not joined.
They also shared a bladder, an anus and the lower part of the
rectum.
Each girl had two vaginas, which the surgeons joined to make one
each. Their fallopian tubes and ovaries are normal, and they will
be able to bear children.
The surgeons broke the girls’ flattened pelvic bones and pulled
them together to bring their legs into a position that is expected
to allow them to walk normally.
Head of paediatric surgery at Red Cross Prof Heinz Rode, who was
also on the team, said Zinzi had proved the more difficult of the
two because her skin had not been pliable enough to completely
cover the 12cm wound left by the operation.
There was still a four by three centimetre gap at the back of
her buttocks, which would eventually be covered by a skin graft.
Her blood was completely replaced three times during the
operation. Rode said most of the bleeding was from the fracture of
the pelvic bone.
The twins, who now each weight about six kilograms, were put
into adjacent beds in the ICU, where they were put on ventilators,
drips and electronic monitors.
”It’s very anxious moments now. The operation was a very
protracted operation. There was very long anaesthesia…. there is
always the risk of infection,” said Rode.
Staff were concerned about Zanele’s slightly high pulse rate.
”The next 72 hours will remain very important hours for us,” he
said.
The operation was the 35th separation carried out at Red Cross.
The cost — an estimated R100 000 — will be borne by the State.
Asked how he felt on finishing the operation, Rode said it was a
”fantastic” feeling.
”The 19 hours really flashes past. One is so involved, time is
immaterial.”
The children’s mother, Nomsa, was at the hospital, but did not
speak to the media. Doctors said she had been advised to sleep on
Wednesday night rather than wait for the result of the operation. – Sapa