Conjoined twins separation is a rare and complex operation performed for twins born joined together, joined at the chest, abdomen, pelvis, head or elsewhere. Its goal is to separate the twins while preserving, as far as possible, the life and function of each, and not every case can be separated.
It begins with a careful assessment using MRI, CT and heart and vascular tests to identify the shared organs, followed by long planning involving paediatric, cardiac, neuro and plastic surgeons, anaesthetists and intensive care doctors. The operation is done under general anaesthesia by two teams, sometimes in stages, and skin expanders are occasionally used beforehand. The union is then divided, organs are reconstructed and the wounds are covered.
Surgery may take many hours and is followed by intensive care and a hospital stay of weeks to months, with possible further operations. The outcome depends on the shared organs and on each child's condition, and no specific result can be promised; the treating team decides each case individually.
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To give each child the chance of a better, independent life when the medical team judges that separation is possible and that its benefit outweighs the risks. In some cases separation is not possible or not appropriate.
No. It depends on where the twins are joined, which organs they share, such as the heart, brain or liver, and the condition of both children. A multidisciplinary team decides after a full assessment.
Preparation includes detailed imaging and tests of the heart, kidneys, liver and brain, and simulation or 3D models may be used. Planning can take weeks or months. No medicine is stopped unless the treating team advises it.
Under general anaesthesia and with two surgical teams, the union is divided gradually while the shared organs are protected, divided between the twins or reconstructed. The wounds are then covered with skin and sometimes with prosthetic materials. The operation may be done in stages.
The twins spend a period in intensive care, then a long stay in hospital with physiotherapy, nutrition and follow-up. Later reconstructive operations may be needed, and recovery time varies greatly from case to case.
The early outcome becomes clear within days of the operation, while the functional result emerges over months or years of follow-up. No outcome can be guaranteed, and the twins need long-term follow-up.
The risks are significant and include bleeding, infection, anaesthesia problems, failure of an organ and delayed healing, and in complex cases they may include death. The team explains them frankly to each family.
Yes. Scars remain where the twins were joined, and their appearance varies with the size of the wound and how it was covered. Cosmetic operations to improve them may be done later.
A long stay of weeks to months is often needed depending on the twins' recovery, and the treating doctor decides when it is safe to travel.
It is made after a full assessment, a thorough explanation to the family and their informed consent, with a multidisciplinary team considering the interest of each child. Postponing or not performing the operation may sometimes be recommended.
