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CNN Sunday Morning

Interview With Doctor James O'Neil

Aired June 23, 2002 - 11:17   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KYRA PHILLIPS, CNN ANCHOR: Well, a set of conjoined twins has made the long journey from Egypt to seek help from doctors in the United States.

Mohammad (ph) and Ahkmad Ebraham (ph) were born last year in a remote village in Egypt. They have separate brains, but share a critical blood vessel. Doctors in Dallas are trying to find out if there is a chance to successfully separate these twins.

Doctor James O'Neil from Vanderbilt University has participated in separating 17 sets of conjoined twins. He joins us from Nashville, Tennessee this morning.

Good morning, Dr. O'Neil.

DR. JAMES O'NEIL, PEDIATRIC SURGEON: Good morning, Kyra.

PHILLIPS: Well, let's talk about how complex the surgery is. And you were telling me that this is even more rare because of the brain tissue that's shared.

O'NEIL: The exact amount of brain tissue that is shared, of course, will need to be determined from special imaging studies. But just looking at the external appearance, certainly, there would be an expectation that there would be a significant amount of brain shared, and because of the way the two heads are joined, that the primary drainage for blood is shared. That makes this an extremely complicated and difficult undertaking.

PHILLIPS: Wow. What causes a birth like this?

O'NEIL: Nobody knows exactly what initiates it. But the most commonly accepted theory is that a doubly fertilized ovum, or egg, usually splits to form two identical twins. But if that gradual division is interrupted, and so there are remaining connections, then you have conjoined twins who are, indeed, identical, but they're still joined together.

PHILLIPS: So, you've seen the pictures. You've been sort of, taking a look at this case. What kind of chances are we talking about, that these two could be separated and both would survive?

O'NEIL: Well, I think it would be preliminary for me to predict that without more specific information. But if the imaging studies do indicate that there's a significant amount of joining of the brains, and that they share the main venous drainage system, then that would be a very risky undertaking, and the outcome would be guarded.

On the other hand, if it turns out that it's fortunate and that the brain tissues are adequately separated, separated apart, then there is the potential that the venous drainage might be divided and shared between them. But, again, that's a very, I would say, a lucky happenstance if that occurs.

PHILLIPS: Now, you've separated 17 sets of conjoined twins. Kind of put us in the mind-set here of this family, and these doctors and, you know, the process, what they're dealing with, the decisions that they have to make.

O'NEIL: I think that this is a very private moment for everybody involved. And the important thing to be able to accomplish at this point in time is a thorough evaluation, so that an appropriate level of informed consent can be provided to the family. And this may take, actually, some time, with multiple explanations and drawings, and things like that. So that the family is able to maintain a level of control that's appropriate.

PHILLIPS: Can they coexist in a conjoined state?

O'NEIL: It's interesting. Our own group has followed a set of conjoined twins, joined at the head, for over 30 years. And they've been seen on television, and things like that. They have decided not to be separated.

And I think that we know that if they -- if there was an attempt to separate them, clearly, only one could survive, at most. And so they decided to remain together. And they've lived together in a bit of an altered fashion, but they've certainly have been able to take their place in society.

PHILLIPS: Dr. James O'Neil from Vanderbilt University, thank you so much. We're definitely going to be following this case, so I bet you and I will be talking again.

O'NEIL: You're very welcome.

PHILLIPS: Thanks, doctor. Well, follow the twins' progress through the week by logging on to our Web site at cnn.com, AOL keyword: CNN.

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