Adult Siamese twins face four day separation operation
Ladan and Laleh Bijani, 29-year-old Iranian twins born joined at the head, will walk into a Singapore operating room on Sunday and sit down for separation surgery that is expected to last days and could kill one or both of them.
Laleh, the quieter but stronger-willed sister, decided they would walk into the operating room as a show of courage despite the risks, said Dr Keith Goh, the neurosurgeon who will lead the procedure.
“Ladan actually wanted to take a sleeping pill and go in asleep, but Laleh said ’No, we’re going to walk into the theatre’,” he said.
After a lifetime of compromises on everything from deciding when to sit down to what career to pursue, the pair have decided they would rather risk death - or being left brain dead – than go on living joined together.
German doctors concluded in 1996 that surgery on the sisters was too dangerous because they share a vein that drains blood from their brains.
American neurosurgeon Benjamin Carson, who will assist Goh with the procedure, has said the sisters each have a 50-50 chance of survival.
“We’ve made our decision to go for the operation. We don’t want even want to think about the risks.
We can’t tolerate thinking about that,” Ladan wrote today in a message to a friend in Tehran. “We are ready for the operation, irrespective of the risks.”
The operation will mark the first time surgeons have tried to separate adult craniopagus twins – siblings born joined at the head – since the operation was first successfully performed in 1952.
To increase the chances of success experts from France, Japan, Nepal, Switzerland and the United States will join Singapore-based surgeons, anaesthetists and radiologists to form a team of 24 doctors, backed by about 100 medical support staff in the operation.
The twins will remain seated throughout the operation – a standard practice in brain surgery – which will last at least 48 hours, Raffles Hospital said in a statement. Medical experts have said it could take four days.
One sister will have to have a graft to replace the shared vein, probably a vein taken from a leg.
They will know if the surgery has been successful within the first 24 hours, Carson said.
The mood has been sombre at the twin’s family home in Shiraz, in southern Iran.
“When the television said one or both of them may die, the mother almost fainted,” one relative said on condition of anonymity.
Iran’s foreign ministry spokesman Hamid Reza Asefi said the whole nation was praying for the sisters.
Goh said they are only going ahead with the surgery because of the twins’ resolve to live separate lives.
“We tried very hard to change their minds because it would be the easiest thing to do,” he said. ”But we couldn’t.”
The Bijani sisters, born in Tehran in 1974, have separate brains that lie next to each other in a joined skull. Their heads are connected but their bodies are otherwise distinct.
The twins have wanted to be separated ever since they first opened their eyes, Ladan said last month. The sisters said they long for simple things such as seeing each other’s face.
They arrived in Singapore in November after hearing about Goh’s success in separating 18-month-old Nepalese infants who were also joined at the head.
Both sisters studied law because Ladan wanted to be a lawyer. However after the surgery, Laleh wants to move to Tehran to be a journalist, while Ladan wants to move back home with her parents and continue her studies to qualify as a lawyer.
