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Egyptian twins doing well after separation in Dallas
( 2003-10-13 21:59) (Agencies)

Two-year-old Egyptian twins separated at the crown of their heads were in a medically induced coma on Monday and US doctors said the boys were doing well after spending their first ever night apart.

Dr. James Thomas, director of critical care at the Children's Medical Center in Dallas where the boys were separated on Sunday, said the twins were doing very well.

"They had a very good night. They stayed in good shape. There were no major problems," Thomas told ABC's "Good Morning America" show.

Ahmed and Mohamed Ibrahim were separated about 27 hours after the intricate procedure began and they were given a chance at living independent lives.

Thomas said the big risks now facing the twins were of infection, for which the toddlers were being given antibiotics, and of post-operative swelling in the brain.

The boys will remain in the medically induced coma for several days as they begin the crucial post-operative period. It was the first time they have slept apart from each other.

Asked when doctors would know for sure whether surgery had been completely successful, Thomas said recovery would be gradual and it could take weeks or even months before it was known whether any damage was suffered from the operation.


When doctors came out and told the parents that because of the successful separation they now had two boys, the twins' father had jumped for joy and then promptly fainted, while their mother wept quietly with joy.

"He (dad) passed out cold on the floor but Mom took the news in a much more stoic fashion -- very quietly. You could see the tears well up in her eyes," said Thomas.

During surgery the boys did not suffer major blood loss. They had no pulmonary problems and no significant or unexpected swelling in either of their brains, doctors said, adding it was too early to tell if the boys had suffered brain damage.

Besides infection, doctors are on the alert for improper drainage of blood from the brains of the boys' newly separated venous systems, leakage of spinal fluids and blood clots.

Neurosurgeons completed the most difficult and dangerous part of the operation on Sunday morning -- separating the shared brain material and the shared circulatory systems that feed blood to their brains.

Cranial and facial surgeons finished the operation by repairing damage to their skulls, using tissue from an area around their thighs that had been expanded by balloon-like devices months before surgery.

Even with the separation, the boys still face years of reconstructive surgery to repair the places where their skulls had been fused together, doctors said.

The surgery was the first such procedure since twin Iranian women joined at the head died in July at a Singapore hospital from blood loss and other complications from the neurosurgical stage of their operation.

Doctors said if the boys were not separated, they would likely never walk without help and faced a lifetime of medical problems. They have spent almost all of their lives on their backs, leaving the back of their skulls flat.

The boys, healthy, alert and playful, were more than 6 feet (1.8 metres) long from the toes of one twin to the toes of the other.

They were born in a town 500 miles (800 km) south of Cairo on June 2, 2001.

Conjoined twins at the head account for about one of every 2.5 million births and about 2 percent of all conjoined births. 

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