Surgeons at the Shanghai Children's Medical Center (SCMC) declared on Tuesday that last Thursday's separation of three-month-old conjoined twins was a success. Both girls are in stable condition in the center's intensive care unit.

Conjoined twins are rare, with only one case occurring in every 100,000 live births. About 29 percent of conjoined babies are connected at their chests and abdomens. In many cases, surgeons are able only to save one of the two because of shared or single vital organs.

The twin girls born in Xuzhou, east China's Jiangsu Province, were joined from their breastbones to their navels. Their two hearts were in the same pericardium and they shared one liver. One baby suffered from a heart deformity and a serious lung infection caused dysfunction in her heart and kidneys.

The situation meant that at least one of the twins was at substantial risk.

"It took a medical team of more than 50 seven hours to perform the complicated surgery," said SCMC President Liu Jingfen at a press conference.

Surgeons first cut the shared liver into two parts, leaving each part a complete set of blood vessels and a biliary tract.

Then the babies' shared pericardium was cut to separate the two hearts.

Surgeons took another two hours to reconstruct their chests and abdomens. "We inserted titanium stands into the babies' chests, as there are no ribs to protect their organs," said Chen Qiming, executive director of SCMC's Surgical Department.

Meanwhile, heart surgeons worked on the congenitally deformed heart of the smaller baby.

Piglet skin was grafted over the openings in the babies' torsos, since they lack sufficient skin to close the wounds. Eventually their own skin will replace the grafts.

The babies will have to undergo several more surgical procedures in the next three months.

The surgery is the fifth of its kind performed in Shanghai.

"The surgery is a marvelous example of different technologies and skills performed ... in a children's hospital, and it's always a team effort," commented Dr. Louis Cooper, former president of the American Academy of Pediatrics, who visited SCMC recently.

(China Daily September 15, 2004)