“This is a very rare operation, performed so far in the world only about 20 times and for the first time in Israel, in one-year-old babies.”
(photo credit: Soroka University Medical Center)
A team of doctors performed a rare operation for the first time in Israel, separating twins attached at their heads, a rare condition called craniopagus twins.
The 12-hour procedure took place last Thursday at Soroka-University Medical Center in Beersheba on one-year-old twin girls who were born in the hospital last August. Their heads were attached at the back.
“This is a very rare operation, performed so far in the world only about 20 times and for the first time in Israel in one-year-old babies, one of the youngest in which this procedure was performed,” said Dr. Mickey Gideon, director of pediatric neurosurgery at Soroka. “The next few days will be critical in the process of the twins’ recovery.”
Dozens of staff members were involved in the procedure and have been working with the parents since the birth of their daughters. The doctors leveraged advanced equipment and technology, some of which had to be brought to the hospital especially for the procedure. This included 3D modeling, virtual reality and special monitoring devices.
Specifically, they used STRATASYS, 3D4OP 3D models based on images from MRI, CT and angiography scans that simulated the complexity of the connection of the blood vessels, meninges, skull bones and skin of the twins.
Using the VR model called Surgical Theater, the team was able to make simulations of the procedure and plan it in the most exact manner. Dozens of simulations of all the stages of the operation were performed in each of the models before the day of the surgery.
An analysis of how best to separate the girls was done in several stages. The treatment team introduced skin and tissue extenders several months ago to produce excess skin that was used to close the scalp of the two girls after the separation.
The twins have undergone extensive tests and been under continuous medical monitoring over the past few months, including of their cardiac and respiratory function.
According to the hospital, a dedicated team of 50 professionals was on call to be ready for the operation. This included neurosurgery, plastic surgery, pediatric anesthesia, pediatric intensive care and brain-imaging specialists.
During the surgery itself, after the separation of the blood vessels was successful, the bones were separated. The doctors then split into two teams to work in parallel in two separate operating rooms, performing a reconstruction of the skull of each of the girls and closing the skin.
An analysis of how best to separate the girls was done in several stages. The treatment team introduced skin and tissue extenders several months ago in order to produce excess skin that would be used to close the scalps after the separation.
Over the past few months, the twins have undergone extensive tests and have been under continuous medical monitoring, including their cardiac and respiratory function.
According to research published by the University of California’s UC Davis Health last year, craniopagus twins occur in about one in every 2.5 million births.
“I am very proud of our teams, of all the specialists that engaged in this challenging and complex event,” said hospital director Dr. Shlomo Kodesh. “I wish complete healing for the twins and their family.”
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