A conjoined set of twins (Mercy and Goodness Ede) that had one liver, a protruding tummy and a lower chest were successfully separated, in a 12-hour surgery involving 78 medical personnel, at the National medical center, Abuja.
The leader of the team that performed the surgery, pediatric surgeon Professor Emmanuel Ameh, said the twins had to be monitored for 15 months before the separation was done because the twins needed to grow well in order to withstand the complex surgery. He noted that nutrition and infection control were critical in the preparation.
According to Professor Emmanuel Ameh of the National medical center, Abuja:
“One of the major challenges was that the twins came with their intestines bulging out of the lower part of the tummy, which we quickly resolved.
We also needed to determine if they could survive separately after separation. We found out that they had two separate hearts that were normal, but with a common cover. They also shared the lower half of the chest and there was only one liver serving the two of them. Other organs were separate and normal.
We celebrated their first birthday in the ward still conjoined. The surgery was performed on November 14, 2019. By that time they were 15 months-old. A total of 78 medical staff was involved in the 12 and a half hour surgery. We even planned to spend 48 hours, if there was a need for it. After that, the twins spent a week at the Intensive Care Unit before they were taken to the ward.
If the parents had the means, they would have gone abroad like some other Nigerians and spent at least an equivalent of 20 million Naira in foreign currency. It is cheaper doing the surgery here. We cannot quantify the amount spent on the surgery.”
Mercy and Goodness Ede are now well enough to go home six weeks after surgery, according to Professor Emmanuel Ameh.
The twins were born on August 13 last year but Professor Ameh said the surgery was delayed until November because of some complications.
Aside from being joined at the chest, the twins were born with a condition known as omphalocele, a birth defect that left a section of their intestine sticking outside their navel, Ameh told CNN.
Professor Ameh said the girls underwent surgery to repair the area that had been torn open at the navel and doctors had to wait for many weeks for them to recover from the procedure. They also had to manage a number of complications in the months leading up to the separation in November.
The surgery to separate the twins happened in November last year but details have only just been released by the hospital, because they wanted to ensure there were no post surgery complications.
Professor Ameh said plastic surgeons on the team were worried that a large section of the girls’ chest would be open and at risk of being infected once they were separated and they had to create artificial skin large enough to cover the area, which took several weeks.
“We needed to determine if they could live independently when they are separated. We found out that they were sharing a diaphragm and one liver was serving both of them, but all other organs were separate.
We also had to get some medical equipment that were not available.”
The girls are the first to be successfully separated at the government-run specialist center, National Hospital spokesman Dr. Tayo Haastrup.
It took around 13 hours for the team working from two operating theaters at the hospital to separate the twins, according to the hospital.
According to Dr. Tayo Haastrup:
“We are just happy and proud that the team that worked on this surgery were all Nigerians. It was done in Nigeria and the parents didn’t have to go outside the country.”
Dr. Haastrup said the surgery, which runs into thousands of dollars, was done free of charge to the parents, who work in menial jobs and would not have been able to afford the surgery.
It was not the first time that conjoined twins were separated in a similar operation in a Nigerian hospital.
On May 14, 2018, a team of surgeons successfully separated four-month-old conjoined twins at the Federal Medical Centre, Yola.