Highly skilled specialist teams work in relays
SEPARATING conjoined twins is one of modern medicine's most demanding and highly skilled tasks.
The procedure generally involves conducting a raft of pre-surgery tests, blood work, X-rays, CT scans and ultra-sound reports which determine the separation procedure itself.
A detailed, timed surgery plan outlines the whole procedure and work is allocated to specialists.
Surgical teams are assigned, each with a single, specific task. Once they complete their task, the next team moves forward to begin their procedure. The other team rests or goes on standby
Usually between 20 and 30 doctors and nurses are involved.
Each twin is allocated a special monitoring team to gauge their status throughout the procedure.
Indian twins Gita and Sita were separated in a 19-hour procedure. Eight medical teams were involved in that operation.
Throughout any separation surgery, support specialists, including cardiologists, remain on standby.
To June 2009, Great Ormond Street Children's Hospital has handled 21 separation procedures. It has also dealt with nine inoperable cases.
It maintain Europe's most experienced conjoined twins separation team, with the UK's top two specialist surgeons, including Cork-born Dr. Edward Kiely.
The London hospital boasts a survival rate of 80pc for conjoined twins in stable health.
It does not handle 'sacrifice' surgery whereby an attempt is made to render one twin viable.