Twins ‘Doing Well’ in Separation Surgery

After a day of continuous surgery, pediatric neurosurgeons said they had reached the home stretch in a complicated procedure to separate 2-year-old Egyptian twins joined at the top of their heads.

Doctors at Children’s Medical Center Dallas spent the night separating the intricate connection of blood vessels running between the brains of Ahmed and Mohamed Ibrahim – considered the riskiest part of the operation. The boys were doing well Sunday, said Dr. Jim Thomas, chief of critical care at the hospital.

“They are now within striking distance of living independent lives,” he said during a morning briefing.

Once the separation process is completed, surgeons will have to reconstruct their skulls and cover the wounds with skin, Thomas said. That procedure could take as long as six hours.

Doctors have spent more than a year planning the surgery, expected to take a team of 50 to 60 medical personnel anywhere from 18 to 90 hours to finish.

The first step was to remove skin expanders inserted in the boys’ heads and thighs about five months ago. The extra skin and tissue created by the expanders will cover the head wounds once they are separated.

The boys were born June 2, 2001, by Caesarean section to Sabah Abu el-Wafa and her husband, Ibrahim Mohammed Ibrahim.

Dallas-based World Craniofacial Foundation, a nonprofit group that helps children with deformities of the head and face, arranged to bring the boys to Dallas in June 2002 for an evaluation.

A team of specialists determined the boys could be separated, though the risks include possible brain damage and death. The boys’ father told doctors he felt it was worth it to give them a chance at a normal life.

The father spent much of the past year in Dallas with the boys before returning to Egypt this summer. He returned this week with his wife and the twins’ young brother, Mahmoud.

Thomas said the parents were “doing fine.”

“I think the parents are helped in many ways by a very strong faith structure that they have,” he said.

“They have said repeatedly to all the parties involved that this is in God’s hands.”

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On the Net:

World Craniofacial Foundation: http://www.worldcf.org

Children’s Medical Center: http://www.childrens.com