Nice to see you! Conjoined twins who were joined at the head look at each other for the first time after surgery to separate them in Israel
One-year-old twin Israeli girls who were born conjoined at the head, back to back, can make eye contact for the first time after undergoing rare separation surgery.
The operation, conducted at the Soroka Medical Centre in Beersheba last week, required months of preparation and involved dozens of experts from Israel and abroad, the hospital said on Sunday.
The twins, who were born in August 2020, were conjoined at the head and faced away from each other, meaning they had never been able to look at one another.
'This was a rare and complex surgery that has been conducted only 20 times worldwide and now, for the first time, in Israel,' said Mickey Gideon, Soroka's chief pediatric neurosurgeon.
'To our delight, everything went as we had hoped.'
The girls were separated successfully after 12 hours of surgery and are expected to lead completely normal, healthy lives.
Dr Noor ul Owase Jeelani, a British consultant paediatric neurosurgeon at Great Ormond Street Hospital in London, UK, led the 12-hour surgery with the support of a local team at Soroka Medical Centre in Israel.
One-year-old twin Israeli girls who were born conjoined at the head, back to back, can make eye contact for the first time after undergoing rare separation surgery
This photo shows the conjoined twins before they were separated by British surgeon Dr Noor ul Owase Jeelani in a rare 12-hour surgery. While the right image shows the twins after the surgery
The complexity of the surgery meant that doctors had to begin their preparations months before the girls were brought to the operating table
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The complexity of the surgery meant that doctors had to begin their preparations months before the girls were brought to the operating table.
Firstly, a 3D virtual reality model of the twins was constructed to allow doctors to study the intricacies of the operation and plot the best course of action.
Then, inflatable silicone bags were inserted into the twins' heads and periodically expanded over the course of several months before the surgery to stretch their skin.
This excess skin was essential for sealing the incisions in the heads of each twin with a scalp graft after they were separated and their skulls were reconstructed.
The twins have not yet been identified but images published in Israeli media show them wearing bandages around their heads and gazing into each others' eyes.
The complexity of the surgery meant that doctors had to begin their preparations months before the girls were brought to the operating table
One of the conjoined twins is seen here sleeping after she was separated from her twin by the British surgeon
The other twin is seen sleeping with a bandage around her head after the 12-hour surgery in Israel
'Any wrong decision could have been the difference between life and death,' said Dr Lazar, the director of the paediatric intensive care unit at Soroka University's medical centre.
'It was so delicate, as the surgery was performed between major blood vessels in the babies' heads. We all knew that any bleed could have catastrophic consequences,' he told the Times of Israel.
Lazar said the twins were moved to the ICU following the operation where they were sedated and placed on ventilators as they recovered.
On Sunday, after they were stable enough to breathe on their own, they were taken off the ventilators and allowed to meet for the first time, a moment which Lazar described as 'simply amazing'.
It is the first time the procedure has been carried out outside the UK by the team at medical charity Gemini Untwined since it was founded in 2018 by Dr Owase Jeelani.
The team have now completed five separation surgeries since 2006, two of them before Gemini was set up.
Dr Owase Jeelani said: 'I am delighted that the surgery has gone well and the girls, their family and the local team have had a good outcome.
'It is through this process of teamwork and knowledge-sharing globally that we can hope to improve the outcome for all children and families that find themselves in this difficult position.'
This photo shows the surgeons conducting the procedure to separate conjoined twins at the Soroka Medical Centre in Israel,
A close up of one of the screens used by the medical team during a procedure to separate conjoined twins at the Soroka Medical Centre in Israel is seen here
Dr Noor ul Owase Jeelani, a consultant paediatric neurosurgeon at Great Ormond Street Hospital, led the 12-hour surgery with the support of a local team at Soroka Medical Centre
Kamal Rahman, one of the founders of Gemini Untwined, added: 'It's exciting that we have now helped three families from different countries with this lifechanging surgery.'
Mr Rahman said the prevalence of conjoined twins is higher in less developed communities where there is little foetal monitoring, which is where charities like Gemini Untwined can assist.
He said: 'Gemini seeks to provide not only research and technical support to the local medical teams but also financial support to facilitate the complex surgery and post-operative rehabilitation where needed.
'We are presently supporting other families that find themselves in this challenging situation.'
It is estimated fifty such sets of craniopagus conjoined twins, joined at the head, are born around the world every year. Of them, it is thought only 15 survive beyond the first 30 days of life.
With current technologies, which the charity aims to make more accessible, approximately half of these cases would be candidates for successful surgical separation
'They are recovering nicely. They are breathing and eating on their own,' Eldad Silberstein, the head of Soroka's plastic surgery department, told Israel's Channel 12 news.
Conjoined twins
Source: University of Maryland, eMedicine, Great Ormond Street Hospital
Senegalese conjoined twins who were brought to the UK in 2017 to undergo life saving treatment began their primary school education earlier this year in Cardiff. The twins were expected to die shortly after birth, but have survived despite sharing a liver, bladder and digestive system.