Odisha twins to remain critical for ‘one or two weeks’, India’s first craniopagus surgery’s outcome to be decided by recovery

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New Delhi | Published: October 28, 2017 11:01:11 AM

After the successful craniopagus surgery, which involved separation of heads of 28-month-old twins, the doctors at AIIMS, on Friday, said that their condition will remain critical for at least “one or two weeks”

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After the successful craniopagus surgery, which involved separation of heads of 28-month-old twins, the doctors at AIIMS, on Friday, said that their condition will remain critical for at least “one or two weeks”, depending on when they start to breathe without the support of the ventilator. The head separation operation of the twins, Jagga and Kalia is India’s first craniopagus surgery which took 18 hours and involved 40 specialists. After 24 hours of the operation, Dr Girija Prasad Rath, professor, department of neuro anesthesiology and critical care said, “The main concern is that since they were conjoined earlier, it is now a different physiology. They are maintaining blood circulation on their own. This change will have an effect on the functioning of vital organs. They were dependent on each other and are suddenly managing their own physiology. This will take time and will continue to be a challenge for the critical care team,” as per a report by The Indian Express.

The doctors echoed that the outcome of the surgery will depend on the recovery shown by the twins during post-operative care. The three key factors to their recovery, as per the doctors are – their ability to breathe on their own; stable functioning of key organs such as heart, brain and kidneys; and not catching any infection. The doctors are also monitoring if the twins show the ability of the brain to receive, process and interpret sensory stimuli also called “improved sensorium” in medical terms.

Dr Shefali Gulati, chief of the child neurology division, told The Indian Express, “They are on artificial ventilation and their condition continues to be critical. We can state that their condition is not critical only when they regain consciousness and are able to breathe on their own. That becomes very crucial. One of them has earlier had a cardiac dysfunction, and maintenance of cardiac functioning and fluids is very important. It also depends on the recovery of the functioning of key organs like heart and brain. Everything possible is being done.”

Dr Gulati added that Kalia had a seizure after surgery, and has been given drugs to control it. “When they were admitted, the twins did not have seizures. We knew that when they are operated on, their brains will be touched. For that reason, we started them on anti-epileptic drugs. Kalia had a lot of seizures during the first stage and we had to increase the dosage. But even then the seizure was not coming under control. We did not realise that since they had a common venous communication, the drug was being distributed to both. So, we further increased the dosage from 60 mg to 100 mg,” Dr Gulati said, as per the report. She further said that the condition of Kalia is stable after the operation and maintaining the blood flow and intracranial pressure (inside the skull), as well as improved sensorium, will also be key to recovery.

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