USS Clueless              Voyages of a restless mind

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Stardate 20011118.1655 (On Screen): What used to be referred to as "Siamese Twins" (after the most famous ones, Chang and Eng) are more properly called "conjoined twins". It refers to twins (invariably identical) who are attached at one point or another. Sometimes they share body parts. In nearly every case, it's necessary to surgically separate them, because they'll usually die otherwise. Sometimes the connection is minor and the operation is not very involved. But sometimes they are fantastically complex.

There was a case last year where a pair of conjoined twins were separate in London (over the objections of their parents) and in this case there were not sufficient organs between the two of them for both to survive. The surgeons decided that it was necessary to do the operation anyway, condemning one of the twins to immediate death, because it was clear that both would die otherwise. There was one fateful incision which the two surgeons made simultaneously, because it was the one which guaranteed that the one child would die. The other did survive it and has now returned home.

There was another such operation two years ago in the US where a pair of girls had three legs between them, and shared a pelvis. The operation was exceedingly difficult because not only did they have to be separated but it was necessary to produce complete pelvis's for each, among many other problems. This was handled by several teams of surgeons who worked tag-team style. There were neurosurgeons who worked on creating separate spinal columns for both. The whole thing was planned out ahead of time, with each team working out the details of their part of the operation. Again, it happened to be girls and one of them got two legs while the other got only one.

These kinds of operations can be horribly difficult and quite commonly they fail. But there has never been such an operation more difficult than one which took place in Singapore in April. Two girls (again) were born in Nepal connected at the top of the head. This is called craniopagus and it is exceedingly rare -- which is a good thing, because such twins had never before been successfully separated. In a 90 hour marathon operation, surgeons did succeed in separating them. The operation was so horrendously difficult because the brains were actually merged and the blood system was common. So it was necessary for the surgeons to figure out where the proper dividing line between the brains was, and also to make sure that neither separated brain was deprived of adequate blood supply. This operation had never succeeded before. It would not have been possible at all without sophisticated computer technology; the surgeons practiced the operation many times using virtual reality tools. But that doesn't take anything away from both the skill and dedication of the surgeons and the stamina of the girls, who were only one year old when the operation took place.

And both girls did survive the operation. Today they're going home to Nepal; a mundane event that masks a medical miracle. There may never have been a more difficult successful operation in history. (discuss)