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American Morning

Conjoined Twins Set to Undergo Complicated Surgery

Aired August 05, 2002 - 08:33   ET

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

BILL HEMMER, CNN ANCHOR: Want to turn our attention now to medical news. There is a very interesting story today on the West Coast. Two baby girls from Guatemola (ph) -- Guatemala, rather, conjoined at the head, have a chance at separate lives. In about 90 minutes, doctors at UCLA Medical Center will perform a dangerous operation, trying to separate the two girls.
Dr Sanjay Gupta in our "House Call" this morning -- good to see you, Sanjay. How dangerous is it?

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Well it is, as they say, when the rubber hits the road in neurosurgery, this is one of the most challenging, intricate neurosurgical operations.

Let me just back up for a minute, bring everyone up to speed. These babies were born July of last year. At that time, the mom actually underwent an eight-day labor, not a good week for her. The babies were subsequently born and taken to a hospital intensive care unit nine and a half hours away. It was Healing the Children organization that actually intervened and flew the baby up in June of this year. They've already had one procedure done. That procedure was basically to expand the skin around their heads so that when their operation actually takes place, they'll have skin to cover up the new wounds. And that operation, as you mentioned, scheduled for today. Bill, it's hard to know how dangerous it is. It is obviously a very intricate operation. These sorts of operations aren't very common. There has only been five of them done over the last ten years, so not a lot of good data to really base their prognosis.

HEMMER: Chances of survival here, doctor, are what?

GUPTA: Well, you know, they've beaten the odds, as I like to say. Forty to 60 percent of these babies aren't -- never make it. They are stillborn. Thirty-five percent of those babies that live don't survive beyond the first year. So these babies clearly are survivors, and very cute to boot.

The operation is a challenging one. One of the most challenging parts of the operation is that one of the major veins in Maria number one's head actually drains into the back of Maria two and vice versa. That is going to be the most challenging part of the operation, actually separating those veins, making sure all the geometry is correct. They share about 10 percent of the brain tissue between the two. That actually is not a lot, compared to some of the other previously conjoined twins that they have seen, but it's going to be a challenging operation, none the less. Ten hours, probably, at a minimum to do this. It could be a lot longer. Sometimes this operation can take over a day.

HEMMER: Take us inside the womb. How does this occur? How do conjoined twins -- how are they formed inside of a woman's body?

GUPTA: Well, basically, it is a -- they are twins, obviously, and there is one egg, only one egg that actually splits. The problem is, it doesn't completely split, even 12 days after conception. It only partially splits. so what you end up having are shared organs, sometimes shared part of the brain, as you see in this case. The most famous case, actually, the Siam twins, Siamese twins, Chang and Eng Bunker actually shared some of the internal organs. They lived, incidentally, to be 63 without ever having a separation operation. That is not an option in this case. Probably, as these babies are conjoined at the top of the head, mobility will obviously be a real problem, if an operation is not done.

HEMMER: In your estimation, how much better is this science getting? Looking at an operation, a procedure like this, in gauging the chances of success?

GUPTA: Well, I will tell you, you know, one of the neurosurgeons out at UCLA made an interesting comment, and that was that they actually do very intricate operations like this all the time. That is vascular operations -- actually operating on the blood vessels in the brain. That is the most challenging part of the operation. The microscopes are better. The surgical technique is better. The understanding of how the anatomy works.

Bill, in this particular case, they actually remodeled the entire two brains and saw exactly where the blood vessels connected. That cost $10,000, incidentally just to do that. A relatively small amount in the scheme of things, but this sort of modeling, these sort of techniques will make this operation, at least from the get go, a lot more likely to be successful.

HEMMER: Fascinating stuff. You say at least ten hours in the operating room, huh? Possibly longer?

GUPTA: That would be my guess. At least ten, maybe even longer.

HEMMER: Thank you, Sanjay. Dr. Sanjay Gupta in our "House Call."

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