The National Hospital Abuja has successfully separated a set of conjoined twins attached at the chest and abdominal regions.
This feat makes the hospital the first in the history of the country to carry out such complicated separations.
The intricacies of this pioneer feat of ‘home-grown surgical care’, was such that one liver had to be divided between the twins, also aspects of the ribs were fused and had to be separated. Luckily, the twins – goodness and mercy, have their own separate hearts, although enclosed in one pericardium. So the surgeons had to cut the sacs and fuse it for each one.
The surgical team was an all Nigerian team which had 78 staff directly involved in the preparation and surgery which took about 12 hours.
This is the first in the history of the country, as most cases of successful separation of conjoined twins have been those joined at the stomach region only, without the extra complications of needing to separate the liver, chest region or even the heart.
The Minister of Health, Dr. Osagie Ehanire, in addressing newsmen yesterday in Abuja, said, “The two lovely children, who were born in Keffi, conjoined face-to-face at the chest and abdomen, were referred to the National Hospital Abuja 16 months ago. The children had to first be nurtured to stable health by a team of neonatologists, as medical imaging experts conducted tests and studies to determine what and how internal organs were shared or connected between them.
“In a remarkable operation that followed very detailed planning and preparation, a mixed team of paediatric, plastic and cardiothoracic surgeons, led by Prof. Emmanuel Ameh, performed the operation to separate the twins. It was the first successful operation of this type at this hospital and it marks a bold venture into the realm of advanced surgery.
“The successful outcome of this surgery is thanks to the availability of top experts at National Hospital Abuja, their dedication to the profession, the careful planning, the excellent teamwork and administrative support they received”.
Twins are conjoined in the womb when an embryo fails to divide completely during the formation, a condition that can present complex and delicate challenges to teams attempting separation especially when critical internal organs like the liver, heart and intestines are shared or connected.
In addressing how his team deployed their expertise to separate the liver shared by the twins, the team lead for surgery and Chief Consultant and Paediatric Surgeon, Prof Emmanuel Ameh, said, “Yes the liver bleeds a lot, and in sharing the liver, the fact is as human beings we don’t need a whole liver. When we carry out a liver transplant, we don’t transplant the whole liver, we only take a small part of it.
“Every human being can survive with one-third of the actual liver size. For the twins, the size of the single liver they had was actually the size of two livers joined together. In terms of separating it, we had very advanced equipment that helped us to separate it very quickly without losing much blood. Also, for the diaphragm, it wasn’t a difficult thing to separate into two; the cardiac surgeon only had to close them back to sure that the tummy and chest are separated from each other.
“There are other cases of twins that have been separated in the past; the only difference is that all those cases were joined only in the tummy. The biggest challenge that we have most of the time is when the chest is involved, and some aspects of the heart are involved. So, this is the first time that twins joined in the chest and stomach have been successfully separated”.
According to the Chief Medical Director of the National Hospital Abuja, Dr.Jaf Momoh, “The babies were delivered at the Federal Medical Center (FMC) Keffi, on the 13th of August 2018. My attention was first drawn to their needs as a result of inability to meet some of the basic cost of hospital admission.
“Following the assessment of their social status by the hospital, the family was classified as indigent. Thereafter, the management of National Hospital decided to fund the care and entire process leading to and including the major surgical procedure for the separation, as our Corporate Social Responsibility (CSR). We, therefore, ensured that lack of funds did not stop these beautiful girls from having the opportunity to enjoy their lives independently.
“If they had the means, they would have gone abroad like many Nigerians and would have spent not less than an equivalent of N20 million. Converting this to dollars, you will know that it is just about what it takes to do this type of surgery abroad, not to talk of the cost of staying there, flight etc.
“In the long run, we probably spent approximately the amount they would have spent for treatment abroad (excluding cost of flight, accommodation etc.), in terms of the hospital buying the consumables, drugs and providing facilities. We did not count the cost until we had finished; in fact, we are still counting the cost.
“We hope to be able to continue to do this when necessary because the government is supporting and investing in the hospital”.
The Minister of State for Health, Sen. Adeleke Olorunnimbe Mamora, while lauding the remarkable feat by the management and surgical team of the National Hospital Abuja, urged other hospitals and medical professionals to emulate the National Hospital and embrace interdisciplinary harmony which can help the sector move higher beyond what they can think or imagine