Conjoined Twins 'Facing Each Other' To Be Separated

Some of the best medical minds in the country are preparing to separate a pair of 18-month-old twins from Bhutan, who will arrive in Melbourne on Tuesday.

Some of the best medical minds in the country are preparing to separate a pair of 18-month-old twins from Bhutan, who will arrive in Melbourne on Tuesday.

Nima and Dawa Pelden were born facing each other, joined at the lower abdomen and sharing, doctors suspect, parts of their livers and bowels.

The team at Monash University first became aware of the twins last year, and after months of wrangling with both the Australian and Bhutanese immigration departments, the Children First Foundation has at last coordinated for the twins to travel to the Melbourne Royal Children’s Hospital to undergo the life-changing procedure.

“It’s a good time to separate them,” said paediatric surgeon Dr. Joe Crameri. “Their life is getting very complicated now they’re getting old enough to mobilise when they’re essentially facing each other.”

Nima and Dawa Pelden are joined at the lower abdomen, but doctors are confident they can separate them. Photo: Supplied.

The key areas of concern will be the liver and the bowels, he said, with doctors hoping that the “plumbing” to the liver isn’t also connected.

“All conjoined twins are unique in the way they are connected,” he said. “This set we expect will be predominantly connected in the abdomen. We’re hoping we don’t have to deal with structures in the chest.”

Another key area of concern is excessive bleeding from the liver, which sees plenty of blood flow through it. However, the liver is a “forgiving organ”, said Crameri, and in children has the ability to regenerate.

Dr. Joe Crameri, who will be on the surgical team. Photo: Ten.

A large team of doctors, including surgeons, intensive care specialists, anesthetists and paediatricians, will be needed for the surgery, but they have no idea how long the process could take.

“I could make up a number -- I think I said this morning six to eight hours -- but until we do the reports, the reality is I don’t know,” said Crameri.

The next step will be to physically exam the twins once they arrive in hospital, with more detailed scans scheduled for later in the week.

Medical Team Is "Confident" They'll Separate Conjoined Twins Successfully

Doctors will then formulate a plan of attack, and lock in a date.

With the rudimentary data available, doctors believe both twins have an equal risk of survival, are confident they’ll be separated in one surgery.

They also don’t believe the surgery will be anything like the marathon 32-hour surgery to separate conjoined twins Krishna and Trishna in 2009, who were born with their skulls and brain tissue fused together.

Nima and Dawa Pelden. Photo: Supplied.

Crameri said they’ll be relying heavily on the anaesthetic and intensive care teams involved in that surgery, which took place in the same hospital, but noted that the surgical team would be slightly different, due to the different areas of joining.

If all things go well, it’s likely the twins and their mum will be staying with the Children First Foundation team for rehab for another six months.

All up, the surgery is set to cost about $350,000 -- that’s $250,000 for the surgery itself, at humanitarian rates, and another $100,000 for rehab.

The money has largely been fronted by donations from the Australian public, said Children First Foundation CEO Elizabeth Lodge.

Although the target hasn’t yet been reached, Lodge is confident they’ll manage it.

“We will meet that target because we know how generous the Australia community are,” she said.

“As [Nima and Dawa’s mum] said, they are two independent girls, but they are not independent. And now they have a chance of that.”

Photo: Children First Foundation.