News Compass

Monday, July 07, 2003

Singapore: Iranian Twins Ladan and Laleh Bijani - The Operation Begins

Ladan and Laleh Bjiani

We take time off to be with Ladan and Laleh Bijani, 29-year old Iranian twins, who are conjoined at the head.

Ladan and Laleh Bijani were born in Firouzabad in southern Iran in 1974. Ladan and Laleh are qualified lawyers.

They will be undergoing a very major operation to separate them. They will be under the surgical knives of a team of Singaporean doctors from Raffles Hospital.

And we, the readers of News Compass, with the rest of the world, pray for their well-being and for the delicate operation to go smoothly and successfully.

Background:

Ladan and Laleh are refered to as craniopagus twins - conjoined twins connect at their heads. Craniopagus twins occur once in every two million live births. Successful separation is rare.

Experts rate their survival chances at 50-50. The risks are considered extremely high and could result in the death of one or both of the sisters. However, they have both said they are prepared to accept the risks for the chance to live their lives as separate individuals to be able to look each other in the face after 29 years.

Singapore doctors had successfully separated infant Nepalese twins Ganga and Jamuna last year.

With Laden and Laleh, Raffles Hospital will become the first in the world to attempt a surgical separation of a pair of adult craniopagus twins.

The mercy mission is codenamed "Operation Hope". The $288,000 cost of the surgery is being underwritten by Singapore's Raffles Hospital and the doctors involved have all waived their fees. Singapore's small Iranian community have donated blood to the city-state's national blood bank to support the twins' operations.

At time of writing this, the neurosurgeons have open the joined skulls and are trying to ensure blood supplies to both brains by fashioning a bypass from a vein taken from one of the Iranian sisters' right thighs.

Before dawn of Monday, surgeons began stitching a vein taken from Ladan's thigh to one of the twin's brains to compensate for the removal of the shared vein, chief surgeon Doctor Kumar said.

Classical music played softly as surgeons worked simultaneously in tight spaces in front of and behind the twins, who are sitting in a custom-built brace connected to an array of lines feeding them intravenously and monitoring their vital signs.

Click on above image to see how the separation is done

Surgeons (L to R) Dr Dennis Rohner, Dr Beat Hammer, Dr Ivan Ng, Dr Ben Carson, Prof. Walter Tan, and Dr Keith Goh and rehearse an operation to separate conjoined twins Ladan and Laleh Bijani from Iran at Raffles Hospital in Singapore in this July 5, 2003 photo. The two adult Iranian sisters are undergoing an unprecedented 48 hour operation in Singapore July 6, 2003 to separate them at the head. Photo by Handout/Reuters

The operation will be led by consultant neurosurgeon Dr Keith Goh, who was part of the team that operated on the Nepalese twins, and Professor Walter Tan, Medical Director of Raffles Hospital.

A team of six neurosurgeons, six plastic surgeons, eight anaesthetists, seven radiologists and three neurologists will be supported by about 100 other Raffles Hospital medical staff.

The lead surgeons will be paediatric neurosurgeon Keith Goh, and plastic surgeon Walter Tan, the hospital's medical director.

The core team will include six foreign doctors who are flying in to assist in the operation which, if successful, will make medical history. Among them is Dr Ben Carson, director of paediatric neurosurgery at the Johns Hopkins Medical Institutions in Baltimore, who has separated three pairs of conjoined twins.

Singapore General Hospital is also lending two experts, after a request from Raffles Hospital. They are Dr Ong Biauw Chi, lead anaesthetist in the operation on the Nepalese twins, and Dr Winston Lim, a neuroradiologist. He, too, was involved in the separation of Ganga and Jamuna.

The National Neuroscience Institute is lending five neurosurgeons and neurologists.

Another five doctors will come from the private sector.

Read HERE Latest Report from Reuters (07/07/2003) on the progress.

Iran's President Mohammed Khatami has said the whole country is praying for a successful outcome in the operation. On Monday the Iranian ambassador from the embassy in Jakarta, the nearest to diplomatic mission to Singapore delivered a personal message of appreciation from the Iranian leader to the Singaporean medical team.