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Adult Conjoined Twins Undergo Separation Surgery

Aired July 7, 2003 - 20:43   ET


PAULA ZAHN, CNN ANCHOR: A groundbreaking operation is still under way at this hour, as a team of international neurosurgeons struggles to give conjoined twins a chance at separate lives.
Earlier today, LIVE FROM THE HEADLINES spoke with two of the twins' friends who are anxiously waiting for news right across the street from the hospital in Singapore. They told us that one of the things the twins did to get ready for surgery was to go shopping. They actually bought makeup, clothes, two pearl necklaces, their first purchases for their individual lives.

Our medical correspondent Dr. Sanjay Gupta takes us through what both the twins and the surgeons are experiencing during this amazingly complicated and challenging surgery.

Good evening, Doctor.

Just for point of reference, we should explain that you're a neurosurgeon yourself.

Give us some context when you're talking about a procedure that could take as long as four days to complete, a procedure that has never been done on adult conjoined twins.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: That's right, Paula. There's no question.

Neurosurgical procedures are intricate by their very nature, but this is really where the rubber hits the road. As you said, this is a medical first. And there are so few medical firsts anymore. But, actually, separating adult conjoined twins has never been done before. There are so many issues that come into play here. Just the very basic one: Adult brains don't rebound as well from an operation like this as well as children's brains do.

Paula, you and I talked so much about the Guatemalan twins last year. And, obviously, those twins went through the operation, are doing relatively well. Who knows how Ladan and Laleh Bijani are going to do from this, very hard to say at this point, given that they're adults, given that they're intelligent women whose brains have sort of been hardwired now for 29 years, very difficult to say; 48 hours of operating have already taken place. That's a lot already, really no end in sight.

Some of the most difficult parts of the procedure have been completed. There is still a lot to do, Paula. It wouldn't be surprising if it takes 48 hours more. ZAHN: I know some of these graphics that we're about to show could make people squeamish tonight. But do the best job you can to explain to us what the most critical aspect of this surgery is and why it is so life-threatening.

GUPTA: Sure.

These are really important graphics. And this is what makes these operations possible, are the models that you're looking at right now, the real models of Ladan and Laleh. As you can see, the skin stripped away there now, just looking at the bony anatomy of these two women. The bones are fused together, as you would expect them to be. And now you go ahead and take away the bones and there are the brains.

You can see them, Paula. They're in close approximation, although the neurosurgeons will call those two distinct brains. If you go ahead and take away the brain on the left, you can see that the brain on the right is there almost in its entirety. And then, if you go ahead and flip that around again and take away the brain on the left, there is the brain on the right again in its entirety.

Paula, the question you asked about the most intricate part of this procedure has to do with that blue blood vessel that you saw in the back there. There was one blood vessel coming down. There should be two. What surgeons spent a lot of time doing today was actually taking another vein from one of the twins' legs and actually using that vein to create another vein in the brain, a very intricate procedure. That's what was done. How it is going to turn out, only time will tell that, Paula.

ZAHN: Well, Sanjay Gupta, thanks for the medical input.

Before we move on, I just want to share with our audience some of what one of the twins had to say before she went into surgery. She said they were confident and strong, but went on to say in a message to a friend -- quote -- "We made our decision to go for the operation. We don't even want to think about the risks. We can't tolerate thinking about it."

And Dr. Sanjay Gupta explaining why they thought that way.

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