Rital and Ritag Gaboura, 11 months-old twins who were born with their heads joined together, were successfully separated by surgeons at Great Ormond Street Hospital, London, England. According to experts at the hospital, one 1 in every 10 million twins joined at the head survive this extremely rare condition.
Craniopagus are conjoined twins whose heads are fused together. The term comes from the Latin word Cranium and the Greek Pagos, which refers to something fixed. About 5% of conjoined twins are craniopagus. Approximately 40% of twins whose heads are fused are stillborn or die during childbirth, while a third die within 24 hours of being born.
Rital and Ritag (Facing the World)
Rital and Ritag were born in Khartoum, Sudan. They were born via C-section. UK charity Facing the World raised money and arranged for their trip to England and their separation treatment.
A hospital spokesperson says the baby girls do not appear to have suffered any neurological side effects.
Bloodflow to the brain was a complicated process in these two girls. Half of the blood in Rital’s brain was supplied from her sister, who also drained most of it back to her heart. This can cause considerable changes in blood pressure in the brain, which seriously raises the risk of neurological damage.
Their parents, who are both doctors, said:
“We are very thankful to be able to look forward to going home with two separate, healthy girls. We are very grateful to all the doctors who volunteered their time and to Facing the World for organising all the logistics and for paying for the surgery. We feel very lucky that our girls have been able to have the surgery that they needed, but we also know of other children who need complete sponsorship and families who are searching for someone to help them.”
Rital and Ritag after the operation (Facing the World)
There has been no difference post-op in the way the girls react to stimuli and tests, the doctors report. This means there is a good chance they have not suffered any neurological side effects. However, as they are so young, it is difficult to be sure.
The twins’ parents approached charity Facing the World for funding for their possible separations. They arrived in England in April 2011 and were hospitalized at Great Ormond Street Hospital. David Dunaway, head of the craniofacial team, and team donated their services.
By the time they arrived in England Ritag’s heart was already beginning to fail. Their separation occurred in four stages. In May 2011 they underwent two surgical procedures, and tissue expanders were inserted in July. The final separation took place on 15th August.
Within days they were out of the ICU and in the general ward, playing and interacting as they used to before.
In its web site, Facing the World wrote:
“Their laughter and delight in the world has been an inspiration throughout the months of worry. Very soon, their parents will be able to fulfill their dream of taking home two healthy, seperate daughters.”
Facing the World informs that with such a large project as this one, a raft of different people were involved. Facing the world is paying for the hospital costs.
The Cranofacial Team at Great Ormond Street Hospital donated their services, as did several other health care professionals, including pediatricians, radiologists, cardiologists, nephrologists, anesthesiologists, endocrinologists, specialist nurses, therapists, and play specialists. Great Ormond Street Hospital is the most experienced in the separation of conjoined twins in Europe.
The twins were brought to the hospital by CATS (The Children’s Acute Transport Service). The AlFayed Foundation paid for all air transportation.
The Sick Children’s Trust provided housing for the twins’ parents. Anatomical models needed to plan surgery were provided by Cavendish Imaging.
Written by Christian Nordqvist