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Doctors Consider Separating Conjoined Twins

Aired July 02, 2002 - 14:42   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: Big news in Dallas, Texas today, where doctors are looking at the fate of conjoined twins. Doctors have been evaluating Mohamed and Ahmed Ibrahim to see if they can be separated.

CNN medical correspondent Dr. Sanjay Gupta joins us now with more on today's big operation -- Sanjay.

SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Well, I'll tell you, this one of those amazing things in neurosurgery, Kyra. Conjoined twins, Siamese twins, I guess one of the more common names for them. Not a very common thing and not very many of these operations have been done successfully over time.

Let me just point out a few of the different possibilities here. As we've seen pictures, I think, of these two twins, Mohamed and Ahmed, actually connected now at the head. As you see them, surgeons are thinking about all sorts of different possibilities and actually being able to separate them.

The various possibilities, one is that they would both be separated and both do just fine. Possibility number two is that they would be separated but only one would survive. The third possibility, perhaps the worst of all, would be that they would both die.

The fourth possibility is that they would both survive but have significant neurological problems, either one or both of them. And the final possibility is that they would remain together, conjoined. And that is not a decision that actually the surgeons have arrived at as of yet.

In fact, one of the surgeons from Egypt, from where the boys came, talked about the fact that they still needed to in fact enlist other sources of help, other sources of information, including religious information. And that's something that is still planned, to go back to Egypt, consult with some of the religious leaders later on next week.

So the decision has not been made yet as to whether or not these boys will actually be separated.

PHILLIPS: Sanjay, I know you have a model there of the brain. Can you sort of do a show and tell for us?

GUPTA: Yes, let me do that. And again, you've seen some of the pictures. I'm going to try to hold this up so you can see it.

PHILLIPS: That's perfect.

GUPTA: But the boys, as you can see, are sort of separated at the top of the head. And while they're separated at the top of the head, they're also turned just a little bit. Why is that important? There are some major blood vessels that actually run right up atop of the head, some of the major draining veins of the brain. Those are very, very important.

And there are some arteries that actually supply the entire brain. And what we have found, what the surgeons have found in Dallas, actually, in looking at all the images, is that those blood vessels are actually intertwined between the two boys. So one boy actually shares some of the blood supply from the other boy and vice versa.

It's going to be very tricky. In fact, probably the trickiest part of the operation, actually trying to make sense of what all those blood vessels are and how to separate them. That will be the key between determining whether both those boys live or not.

PHILLIPS: And you talked a lot about that survival. Is it more than likely that only one of the babies would survive, Sanjay, in a situation like this?

GUPTA: Well, I'll tell you, Dr. Salyer, who's the head surgeon down there, made an interesting comment. He said this is the type of operation that just historically, while very rare, there's only about a 10 percent or so survival -- both survival, with these sort of operations.

And just that -- you know, I'm a neurosurgeon, Kyra, as you know. And just no surgeon would probably like those odds at all. You don't want to go into an operation where you sort of know, based on historical evidence, that there's only a 10 percent survival. But being that this is such a rare situation, that is sort of what they're talking about.

This is as intricate as it really gets in neurosurgery. Separating all of those blood vessels that are very tiny. This is all done under the microscope. And certainly, it's a very challenging process.

PHILLIPS: And no doubt a moral and ethical one, too. Dr. Sanjay Gupta, thanks so much.

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