Dangerous operation to separate conjoined twins

A PAIR of 29-year-old Iranian twin sisters who are joined at the head began a marathon operation yesterday which could finally separate them — or kill them both.

After a lifetime of compromises on everything from when to wake up each day to what career to pursue, Ladan and Laleh Bijani said they preferred to face the dangers of the surgery which could last up to four days rather than continue living joined together.

"If God wants us to live the rest of our lives as two separate, independent individuals, we will," Ladan said.

The twins had said they wanted to walk into the operating room at Singapore's Raffles Hospital as a sign of courage, but they were brought in by wheelchair because they were too tired to stand, hospital spokesman Dr Prem Kumar told reporters.

A team of 28 doctors and about 100 medical assistants are participating in the surgery.

"It's going to be a good day," the lead neurosurgeon, Dr Keith Goh, said as he arrived at the hospital yesterday morning. He said he and his wife spent the morning praying for the twins.

The Bijani sisters, born in Firouzabad, southern Iran, 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 told a news conference last month. They told reporters they long for simple things such as seeing each other's face.

On Saturday, Ladan said they would spend the hours before the operation reading the Quran and performing Muslim ablutions.

Before the operation, doctors conducted four hours of last-minute tests on the sisters to study how blood flows through their brains.

The tests revealed a new medical reason for the surgery to proceed, Goh said on Saturday. The pressure inside the twins' brains was more than twice what it should be.

The sisters each have a 50-50 chance of survival, said Dr Benjamin Carson, a Johns Hopkins neurosurgeon from Baltimore.

The $288,000 cost of the surgery is being underwritten by Raffles Hospital, and the doctors' fees are being waived.

The surgeons' biggest challenge will be dealing with a shared vein which drains blood from the women's brains. German doctors concluded in 1996 that this vein made the surgery too dangerous.