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Lessons learnt from twins' operation, says doctor
DUBAI - One of the five neurosurgeons who operated on the Iranian conjoined twins Laleh and Laden Bijani in Singapore earlier this year, Dr Ivan Ng, Director of the Neurocritical Care Unit, National Neuroscience Institute, Singapore, spoke to Khaleej Times about his experiences of the operation and the lessons learnt from it, while attending the Second Emirates Neurosceince Conference held in Dubai recently.
Dr Ivan Ng described the extensive preparations made by the staff at the Raffles Hospital in Singapore where the operation took place.
"A lot of planning took place for this operation and for nearly six months regular tests were conducted on the twins to ensure that everything went smoothly during the actual surgery.
"Psychiatric tests were also conducted to ensure that the twins were aware of the dangers involved in the operation. But they were quite sure from the very beginning that they wanted to proceed with the surgery, no matter what the cost."
And, it was this determination that finally spurred the team of doctors to proceed with this extraordinary operation.
An extensive medical team was assembled from around the globe to carry out the surgery which was led by neurosurgeon Dr Keith Goh.
Although every preparation was made to counter potential complications arising from the surgery, Dr Ivan Ng said that since the operation was the first of its kind on adult twins joined at the head, no one really knew what to expect.
"There was a time when we wanted to stop the operation as we were rather concerned that if we were to proceed, the twins might die. But their relatives were quite determined to continue as it was the twins wish not to end the operation at any cost."
Then disaster struck in the fourty-eighth hour of the operation, when a large amount of blood was lost. This ultimately led to the death of the 29-year-old twins who died within 90 minutes of each other on July 8, 2003.
The twins were earlier warned by doctors that they had a 50-50 chance of survival.
Asked whether they would consider doing another operation of this kind in the near future, Dr Ivan Ng replied: "We all did a lot of soul searching on our part at the end of the operation and it did lightly dent our confidence for a short while. But after a week-and-a-half of this event, we separated another pair of Korean twins. If there is another case like this, we will definitely review it as we must not get discouraged by this experience but instead, learn from it." The team received criticism from the international medical community after the operation, but Dr Ivan Ng said that the lessons learnt from it were invaluable.
"All I can say is that it is very difficult to comment on whether the twins should have been separated or not, as the decision to do so was taken collectively and by a medical committee which enquired extensively into the matter. And history has shown us that advances in the medical field have taken place by learning from the failures of the past and improving on them."
Dr Ivan Ng also commented on the fallibility of surgeons who are constantly placed on pedestals by patients and their relatives. "We all have learnt a great deal from this tragic experience and have understood the need to study the dynamics of the human body extensively.
"More importantly, we have realised that it is God that made the human body and he made us. And we're not above that."
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