He Sant Joan de Déu Hospital (Esplugues de Llobregat) prepared the separation of Khadija and Cherive, the conjoined twins from Mauritania, with a 3D simulation before the surgery. This health center, a reference for children, managed to successfully separate them on November 8, but it was the first time who carried out an intervention of this type, so He planned and prepared everything to the millimeter, with a three-dimensional model that simulated the girls’ bodies. The conjoined twins arrived in Barcelona on October 26, less than a month old, thanks to Take care of me, the solidarity program of Sant Joan de Déu funded by donations. After the operation, Khadija and Cherive are fine, healthy, and will soon be discharged.
The Barcelona hospital has announced the details of this highly complex surgery this Friday at a press conference attended by the Mauritanian Minister of Health, Naha Mint Hamdi Uld Muknas. “We could go to other sister countries, but we chose Spain because we have a friendship with its government and because “We fully trust the Spanish health system,” said the minister, very grateful to Sant Joan de Déu.
The conjoined twins were born on October 8 in Mauritania joined by the upper part of the abdomen and with a single umbilical cord. Given the impossibility of separating them in their country of origin, the Mauritanian authorities asked Sant Joan de Déu for advice from international cooperation agreement that exists between the Mauritanian Ministry of Health and the Catalan hospital.
A team of health workers from Sant Joan de Déu went to look for the girls in Mauritania and picked them up. “at the foot of the slope”, according to the neonatologist Ana Alarcón, who accompanied the Siamese twins on this trip. The girls were transferred to Barcelona in a Air Force plane Spanish. “After a four hour flight, When they arrived here, the Sistema d’Emergències Mèdiques (SEM) was also at the foot of the slope waiting for them,” explained Alarcón. They went straight to Sant Joan de Déu.
Planning and preparation
The doctors at this hospital immediately gave them radiodiagnostic tests to watch the extent of connection between them, that is, what organs they shared and whether there were bony or vascular connections between both bodies. And they confirmed that Khadija and Cherive were two omphalopagus conjoined twins: They were joined at the bottom of the sternum and had two differentiated livers but connected by a common area of about six centimeters. In the world there is one conjoined twin birth per 250,000 inhabitants: Many are not born or do not survive during the first months of life due to the severity of the connection they present.
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Due to the High complexity of this surgical procedure, Sant Joan de Déu, which was the first time he had separated two twins, made a 3D simulation. “From the radiodiagnostic images we had, we built a three dimensional model [una reproducción física a medida real, en 3D, y virtual de los cuerpos de las siamesas]which was printed with a 3D printer of various textures and colors”, has explained José Quintilla, coordinator of the hospital simulation program. This three-dimensional model was what allowed them to “understand” what the “anatomical relationships” at the bone level, in the internal organs or in the blood vessels that could be “at risk.” “[Esta preparación] It also allowed us to decide What was the best position in the operating room? for equipment or mobility and visibility risks of the medical team,” added Quintillà. During the simulation, there were “two critical moments” that were treated and then did not reproduce during surgery.
This intervention also had an added complexity: it began with an operation and a body but, at one point, after the separation, there was two patients and two interventions, which forced the doctors to have two operating tables in the same operating room to finish operating on the girls. “The surgery had Two phases: that of separation of the shared viscera, in this case the liver, and that of repair of the abdomen of the twins. We did not have to use prosthetic material and we could rebuild it with tissues from both bodies”, he continued explaining Xavier Tarrado, head of Pediatric Surgery of Sant Joan de Déu. The entire surgical procedure took about five hours and some participated in it 20 professionals from different areas of the hospital. The girls were then transferred back to the ICU, where they remained for five days, until the 13th. Since then they have been in the ward and in the next few days they will be discharged.