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Separation of Adult Twins Much Riskier Than With Children

Aired July 08, 2003 - 11:00   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.


DARYN KAGAN, CNN ANCHOR: Up first on CNN, the conjoined twins. Their courageous gamble for independent lives did not pay off. After two days on the operating table in Singapore, the Iranian women died today within hours of separation.
Let's talk with our own Dr. Sanjay Gupta about the risky and complicated procedure. Good morning, but a sad morning.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: It really is. And it was a historical morning for medicine, no question about it. People talking about this operation for quite some time. It had never been attempted before, the separation of adult conjoined twins.

Some of the early obstacles of the operation had been overcome. And there was some optimism in the air about halfway through this four-day operation. One of the big blood vessels that had to be rerouted, that had been achieved.

But, Daryn, as you mentioned, the bleeding became uncontrollable, first for Ladan at about eight hours ago, nice hours ago now. And then Laleh, as well, her sister, a couple of hours after that. Both succumbing to significant blood loss.

Listen, Daryn, one of the things that's going to come up a lot, and I think people are already starting to talk to you, is the fact that this is an elective operation, should it have been done? And I think these are tough questions for doctors and for patients, certainly.

We actually talked to Dr. Ben Carson about that very issue before he left for Singapore. This is what he had to say.

(BEGIN VIDEO CLIP)

DR. BEN CARSON, NEUROSURGEON, JOHNS HOPKINS: Recognizing the incredible desire they have for this, and how miserable their lives are, and that they would rather face death than to continue in that manner, recognizing that we do at least have a 50 percent chance of success, putting all that together and recognizing they will continue to seek to be separated even if we don't do it.

(END VIDEO CLIP)

GUPTA: Sort of remarkable. So he's basically saying, You know they were going to get this separation operation somewhere somehow. Dr. Carson, Dr. Goh thought that they would be the guys that could best to do it. The outcome was unfortunate, but that was the situation leading up to it.

KAGAN: We saw the interviews with the women before they underwent the operation. These were educated, thoughtful women. They obviously put a lot of thought into what they wanted to do. And this was their choice even though it was elective.

GUPTA: That's right. An elective operation they probably would have lived a normal life span, although I think everyone agrees not a normal life. One wanted to be a lawyer, one wanted to a journalist. One wanted to live Tehran, one wanted to move back to her hometown. They were different women and they wanted to be different physically as well.

KAGAN: And different individuals. Let's talk about some of the science behind this. First of all, the big thing that was unusual there, trying to do this on adults. We've seen this on children. What were some complications that came into play because they were grown?

GUPTA: Everybody agreed doing this on adults probably much more difficult than doing this on children. Lots of different reasons.

First of all, from the very basic things like actually cutting through the bone. It's much thicker in adults, especially where it's conjoined. And that was a challenge. It took a lot longer than they thought it was going to take.

Also, actually getting these blood vessels sort of rerouted. Much more of a problem in adults versus children.

And then, Daryn, brains had been fused together for 29 years. And so actually getting through those brains much more challenging in an adult than a child where the brain may have been more easily pulled apart.

But I think more fundamentally than that, kids are resilient. They tend to bounce back from operations like this. Adults have a much harder time with sort of thing. Any sort of operation would have been more difficult in an adult than a child, typically. Especially something like this.

KAGAN: Conjoined twins, obviously a very rare condition. So not a huge demand from this type of operation. But will anything be learned?

GUPTA: You know, it's an interesting question. I've actually talked to some of my colleagues about that. And I think a lot will be learned. Certainly about these blood vessels and how the rerouting occurs.

Though I think more historically, I think it's a very interesting moment in medicine because the technology has advanced to the point now where children if they born conjoined will likely be able to undergo operations pretty quickly in life, early on in life, even as newborns. We may never see adult conjoined twins actually get this sort of operation again. There are existing adult conjoined twins alive in the world today. I'm sure they were following the story of the Bijani twins very, very closely. I don't know how they feel right now. I wonder how they feel about this, if this makes them less optimistic or what. I sure it probably does. But this may be the last time we see something like this.

KAGAN: And they might have -- the conjoined twins that are still out there might have different wishes and desires. They might be happy living their lives.

GUPTA: That's right. Exactly.

KAGAN: Dr. Sanjay Gupta. Thank you, Sanjay.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com






Aired July 8, 2003 - 11:00   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DARYN KAGAN, CNN ANCHOR: Up first on CNN, the conjoined twins. Their courageous gamble for independent lives did not pay off. After two days on the operating table in Singapore, the Iranian women died today within hours of separation.
Let's talk with our own Dr. Sanjay Gupta about the risky and complicated procedure. Good morning, but a sad morning.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: It really is. And it was a historical morning for medicine, no question about it. People talking about this operation for quite some time. It had never been attempted before, the separation of adult conjoined twins.

Some of the early obstacles of the operation had been overcome. And there was some optimism in the air about halfway through this four-day operation. One of the big blood vessels that had to be rerouted, that had been achieved.

But, Daryn, as you mentioned, the bleeding became uncontrollable, first for Ladan at about eight hours ago, nice hours ago now. And then Laleh, as well, her sister, a couple of hours after that. Both succumbing to significant blood loss.

Listen, Daryn, one of the things that's going to come up a lot, and I think people are already starting to talk to you, is the fact that this is an elective operation, should it have been done? And I think these are tough questions for doctors and for patients, certainly.

We actually talked to Dr. Ben Carson about that very issue before he left for Singapore. This is what he had to say.

(BEGIN VIDEO CLIP)

DR. BEN CARSON, NEUROSURGEON, JOHNS HOPKINS: Recognizing the incredible desire they have for this, and how miserable their lives are, and that they would rather face death than to continue in that manner, recognizing that we do at least have a 50 percent chance of success, putting all that together and recognizing they will continue to seek to be separated even if we don't do it.

(END VIDEO CLIP)

GUPTA: Sort of remarkable. So he's basically saying, You know they were going to get this separation operation somewhere somehow. Dr. Carson, Dr. Goh thought that they would be the guys that could best to do it. The outcome was unfortunate, but that was the situation leading up to it.

KAGAN: We saw the interviews with the women before they underwent the operation. These were educated, thoughtful women. They obviously put a lot of thought into what they wanted to do. And this was their choice even though it was elective.

GUPTA: That's right. An elective operation they probably would have lived a normal life span, although I think everyone agrees not a normal life. One wanted to be a lawyer, one wanted to a journalist. One wanted to live Tehran, one wanted to move back to her hometown. They were different women and they wanted to be different physically as well.

KAGAN: And different individuals. Let's talk about some of the science behind this. First of all, the big thing that was unusual there, trying to do this on adults. We've seen this on children. What were some complications that came into play because they were grown?

GUPTA: Everybody agreed doing this on adults probably much more difficult than doing this on children. Lots of different reasons.

First of all, from the very basic things like actually cutting through the bone. It's much thicker in adults, especially where it's conjoined. And that was a challenge. It took a lot longer than they thought it was going to take.

Also, actually getting these blood vessels sort of rerouted. Much more of a problem in adults versus children.

And then, Daryn, brains had been fused together for 29 years. And so actually getting through those brains much more challenging in an adult than a child where the brain may have been more easily pulled apart.

But I think more fundamentally than that, kids are resilient. They tend to bounce back from operations like this. Adults have a much harder time with sort of thing. Any sort of operation would have been more difficult in an adult than a child, typically. Especially something like this.

KAGAN: Conjoined twins, obviously a very rare condition. So not a huge demand from this type of operation. But will anything be learned?

GUPTA: You know, it's an interesting question. I've actually talked to some of my colleagues about that. And I think a lot will be learned. Certainly about these blood vessels and how the rerouting occurs.

Though I think more historically, I think it's a very interesting moment in medicine because the technology has advanced to the point now where children if they born conjoined will likely be able to undergo operations pretty quickly in life, early on in life, even as newborns. We may never see adult conjoined twins actually get this sort of operation again. There are existing adult conjoined twins alive in the world today. I'm sure they were following the story of the Bijani twins very, very closely. I don't know how they feel right now. I wonder how they feel about this, if this makes them less optimistic or what. I sure it probably does. But this may be the last time we see something like this.

KAGAN: And they might have -- the conjoined twins that are still out there might have different wishes and desires. They might be happy living their lives.

GUPTA: That's right. Exactly.

KAGAN: Dr. Sanjay Gupta. Thank you, Sanjay.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com