In First, Conjoined Israeli Twins Separated in Rare Surgery

The one-year-old Israeli twins were joined at the head and separated in a complex operation last week that involved 50 staff members and months of preparation

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The conjoined twins at Soroka Medical Center in Be’er Sheva.
The conjoined twins at Soroka Medical Center in Be’er Sheva.Credit: Soroka Medical Center in Be’er Sheva
Ido Efrati
Ido Efrati

One-year-old conjoined twin girls joined at the head were separated at Soroka Medical Center in Be’er Sheva last week in the first operation of its kind in Israel.

“This is a rare and complex procedure that has so far been performed in only 20 places in the world, and for the first time in Israel, in this case with very young babies," Dr. Mickey Gideon, director of pediatric neurosurgery at Soroka, said. “The coming days are critical in the process of the twins’ recovery,” he added.

The twins following the operation.Credit: Soroka Medical Center

Some 50 staff members, including two experts from abroad, took part in the operation, which took more than 12 hours. It began with the separation of the girls’ blood vessels and continued with the separation of bone. After that, the team split into two operating rooms, in each of which they reconstructed the skull and stitched up the skin of each girl.

The team that conducted the surgery planned it for months, using  a three-dimensional model based on CT and MRI imaging of the twins. The purpose of the model was to precisely simulate the interfaces of the twins’ organs. Using another virtual reality model, simulations of the surgery were carried out. The hospital said dozens of simulations were performed of every stage of the surgery.

The twins, who were born at Soroka in August of last year, were joined at the base of their heads. In recent months they underwent a series of extensive tests and follow-ups of their heart and lung functions.

As part of the preparations for the surgery, doctors planned how to treat the area of the head that would be exposed during the surgery. “In this case, skin could not be taken from the leg or elsewhere in the body, or from a donor. “Our way to deal with this was by creating surpluses,” Soroka’s chief of plastic surgery, Prof. Eldad Silberstein, said.

Imaging of the twins' heads prior to the surgery. Credit: Soroka Medical Center in Be’er Sheva

To do so, the doctors planted a silicone balloon under the skin of the twins’ heads, that would create extra skin on their scalps. “Twice a week we increased the volume of the balloon by means of a valve under the skin, until we had almost enough skin volume for another head,” he added.

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