SINGAPORE/IRAN: PIONEERING SURGERY TO SEPERATE IRANIAN TWINS JOINED AT THE HEAD HAS ENDED IN TRAGEDY WHEN WOMEN DIED FROM MASSIVE BLOOD LOSS
Record ID:
646073
SINGAPORE/IRAN: PIONEERING SURGERY TO SEPERATE IRANIAN TWINS JOINED AT THE HEAD HAS ENDED IN TRAGEDY WHEN WOMEN DIED FROM MASSIVE BLOOD LOSS
- Title: SINGAPORE/IRAN: PIONEERING SURGERY TO SEPERATE IRANIAN TWINS JOINED AT THE HEAD HAS ENDED IN TRAGEDY WHEN WOMEN DIED FROM MASSIVE BLOOD LOSS
- Date: 8th July 2003
- Summary: (U4) SINGAPORE (JULY 8, 2003) (REUTERS) SLV NEWS CONFERENCE BY LOO CHOON YONG, RAFFLES HOSPITAL CHAIRMAN MCU (English) LOO SAYING: "When we undertook this challenge, we knew the risks were great, we knew that one of the scenarios was that we may lose both of them, Ladan and Laleh knew it too. We were hoping and trying to do better than the worst odds, but alas we didn't make it." SV REPORTERS LISTENING MCU (English) MEDICAL TEAM LEADER, NEUROSURGEON, DR. KEITH GOH SAYING: "What we understood from the intra-operative findings are that the patterns of blood flow through such abnormally joined brains is hard to predict. And when we went through all the final ethnographic studies on Saturday, we certainly did not see some of the features which we encountered during surgery. These changes in blood flow patterns occur, and they can occur in any patient and in any kind of operation. Sometimes the way the human body behaves in surgery is not what you can entirely predict. And that I think is what happened." SLV/SV IRANIAN FRIENDS AND WELL-WISHERS LISTENING (2 SHOTS) SLV NEWS CONFERENCE BY IRANIAN AMBASSADOR TO INDONESIA, SHABAN SHAHADI MOADAB MCU (English) MOADAB SAYING: "For 29 years they said yes to their destiny, but finally they decide to challenge. And in this challenge, science and medicine came to their rescue. The name of the operation is hope, the challenge is lost but the hope will continue. Laleh and Ladan like two butterflies have burnt in the candle of destiny. But it is the light of this candle which gives us hope to continue the endeavour for the betterment of human life." (W3) SINGAPORE (JULY 8, 2003) (REUTERS) SV ZOHRA SALEHINIA, CLOSE FRIEND OF TWINS CRYING
- Embargoed: 23rd July 2003 13:00
- Keywords:
- Location: SINGAPORE AND VARIOUS LOCATIONS, IRAN
- City:
- Country: Singapore Iran, Islamic Republic of
- Topics: Health
- Reuters ID: LVAEWK744MTRB336D8I57NZNENR7
- Story Text: Pioneering surgery to separate Iranian twins joined at the head has ended in tragedy when the women died from massive blood loss on the operating table in Singapore soon after doctors separated their enmeshed brains.
The deaths on Tuesday (July 8) of Laleh and Ladan Bijani, 29, abruptly halted a historic 50-hour operation by a team of 28 specialists and 100 assistants to separate siblings fused at the head, or craniopagus twins, as doctors call the condition.
The twins' homeland of Iran was plunged into shock and grief after television there broke into regular programming to announce the news. President Mohammed Khatami had pledged on Monday to pay the cost of the operation, estimated at $300,000.
At Raffles Hospital in Singapore, hundreds of supporters and friends of the twins wept and hugged each other.
"When we undertook this challenge, we knew the risks were great, we knew that one of the scenarios was that we may lose both of them, Ladan and Laleh knew it too. We were hoping and trying to do better than the worst odds, but alas we didn't make it," hospital chairman Loo Choon Yong told reporters.
Ladan began to lose blood at around 2 p.m. (0600 GMT), and died at 2:30 p.m. (0630 GMT), doctors said. Brain surgery continued on Laleh, who died at 4 p.m. (0800 GMT) Neurosurgeon Dr. Keith Goh, head of the medical team, said the change in blood flow patterns was what probably caused the surgery's failure.
"What we understood from the intra-operative findings are that the patterns of blood flow through such abnormally joined brains is hard to predict. And when we went through all the final ethnographic studies on Saturday, we certainly did not see some of the features which we encountered during surgery.
These changes in blood flow patterns occur, and they can occur in any patient and in any kind of operation. Sometimes the way the human body behaves in surgery is not what you can entirely predict. And that I think is what happened."
Ladan, the more outspoken twin, had wanted to lead a separate life as a lawyer in her home town of Shiraz, while Laleh said before the operation she wanted to be a journalist in Tehran. Both held degrees in law.
The unprecedented operation led by Goh ran into several major complications and took far longer than expected. The women's blood pressure had been fluctuating and surgeons discovered the brains were more closely linked than had previously been thought.
Dozens of supporters of the Bijanis broke down and cried in the hospital. A group of weeping Iranian expatriate women were escorted away by friends.
Iranian ambassador to Indonesia, Shaban Shahadi Moadab expressed his sadness and disappointment at the death of the twins but paid a glowing tribute to their courage in undertaking the operation.
"For 29 years they said yes to their destiny, but finally they decide to challenge. And in this challenge, science and medicine came to their rescue. The name of the operation is hope, the challenge is lost but the hope will continue. Laleh and Ladan like two butterflies have burnt in the candle of destiny. But it is the light of this candle which gives us hope to continue the endeavour for the betterment of human life," he said.
After the operation began on Sunday, doctors opened the joined skull of the pair, peeling a strip of scalp from each woman. The bone proved surprisingly thick, causing delays.
The surgical team then battled to reroute a shared vein on Monday that drained blood from the twins' brains to their hearts. Then five neurosurgeons began the extremely delicate process of prying apart the brains millimetre by millimetre.
Ladan had been considered more at risk after receiving a new vein about the size of a finger grafted from her thigh.
German doctors turned the Bijanis away in 1996, saying it could prove fatal to separate the two. But they were determined to lead separate lives, and came to Singapore in November to undergo months of tests.
Twins joined at the head occur only once in every two million live births, and successful separation is even rarer.
Singapore doctors did a similar operation in 2001 on infant girls from Nepal, but experts said an operation on adult twins was unprecedented.
Goh was assisted by Dr Walter Tan, a plastic surgeon, and Dr Ben Carson, director of paediatric neurosurgery at Johns Hopkins University in Baltimore. Carson separated twin boys joined at the head in Germany in 1987 and six-month-old twin girls in 1997.
The operation has reawakened the ethical concerns that surround high-risk surgery when a life is not at stake. - Copyright Holder: REUTERS
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