Update: Operation on Iranian Twins Ladan and Laleh Bijani - Raffles Hospital, Singapore
LATEST: 3 PM (Singapore Time): Twins' separated, in critical condition11.30 am (Singapore Time): The operation was complicated further when the team discovered that the pressure in the twins' brains and circulatory system was fluctuating.
Neurosurgeons separated the fused heads of Iranian adult twins Ladan and Laleh Bijani on Tuesday but the sisters are in a critical condition, hospital officials announced here.
The 29-year-old twins are said to have lost have lot of blood and are in a critical stage, Raffles Hospital spokesman Prem Kumar Nair told reporters about 2.40pm (0640 GMT).
Mr Nair said Ladan was in a more critical condition than Laleh.
The team of doctors had to contend with unstable pressure levels inside the twins' brains just before they uncoupled the brains and cut through the last bit if skull joining them.
The process was slow and tedious as their brains have been fused tightly together for the last 29 years.
"Please pray very hard for them,' Mr Nair said.
The hospital's general manager of corporate services, Dr Prem Kumar Nair, said that the fluctuations were within 'tolerable levels', but he was not prepared to immediately explain what would happen if that changed.
Dr. Kumar added: "In the process, we have encountered a lot of blood vessels and a lot of tissue that is taking a long time to separate. There is still blood flowing between the two of them. It means that the blood pressure needs to be monitored all the time. We anticipate that the process of separating the brain will continue well into the night and into tomorrow."
The operation is being further complicated because the blood circulation between the twins is unstable.
Dr Marc Mayberg, chairman of neurosurgery at the Cleveland Clinic in Ohio, said that the pressure fluctuations could be fatal. 'If the pressure is due to the fact that there is insufficient drainage from this vein, in either cranium, that could be a life-threatening condition,' he said.
Scroll down to read yesterday's posting on News Compass on this topic
Read Here full report by Lee Hui Chieh from Singapore Straits Times.
Excerpt from H.C. Lee's report :
" SURGERY to separate conjoined Iranian twins Ladan and Laleh Bijani stretches into its third day today, as neurosurgeons tease apart their tightly stuck-together brains, millimetre by millimetre.
Raffles Hospital spokesman Prem Kumar Nair explained yesterday that while the sisters' brains are separate they are very close to each other, because their heads have been fused for 29 years.
'They have to be teased apart very slowly and carefully,' he said. 'It is very fragile and any part of the brain can be ripped apart very easily.'
A problem surfaced yesterday - blood circulation between the twins is unstable, causing blood pressure in the brain and body to fluctuate.
Mr Shaban Shahidi Moadab said that President Mohammed Khatami had agreed that the Iranian government would pay for the twins' operation, which he believed would come to under US$300,000 (S$527,400).
Ladan and Laleh entered the operating theatre on Sunday morning, and at about 9.30pm (Singapore time) that day, the team of five neurosurgeons led by Dr Keith Goh started to separate the twins' skulls.
Removing a strip of bone along the line where the twins' heads fused took more than six hours - almost twice as long as expected - because that area of the skull bone was especially thick, said Dr Nair.
The sisters share a critical, thick vein between their brains. The surgeons decided that this would go to Laleh.
They created a new vein for Ladan by using a graft taken earlier from her right thigh.
It took almost 13 hours for this bypass to be completed.
The painstaking work to separate the brains began at about 5pm and was expected to continue through the night and well into today.
Following developments every step of the way at the hospital were a group of about 15 Iranian expatriates keeping vigil alongside reporters and photographers representing media organisations from around the world.
As the team of 28 doctors and about 100 assistants worked on the twins, who are connected to an array of lines that feed them intravenously and monitor their vital signs, classical music played in the background.
Dr Nair said: 'There is a lot of adrenalin flowing and this keeps them going. The individual doctors have taken breaks whenever they can and the team is still confident.'
Yesterday, hospital officials would not say if one twin was doing better than the other.
After hearing last night's update, the twins' friends were huddled together, dabbing tears from their eyes.
Their best friend here, Miss Bahar Niko, 24, said: 'I don't know what to think or what to say. We'll pray.'
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