Conjoined Iranian Twins, 29, Face Surgery.

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I cannot believe about that story. Kinda late but they get blessed. Here is the story.


Conjoined Iranian Twins, 29, Face Surgery

By D'ARCY DORAN, Associated Press Writers

SINGAPORE - A pair of 29-year-old Iranian twin sisters, joined at the head, said Saturday their fate was in God's hands as they prepared to walk into a marathon operation that could finally separate them — or could kill one or both of them.

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.


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


Sunday morning, they plan to walk into the operating room at Singapore's Raffles Hospital — rather than be put to sleep beforehand and wheeled in — as a sign of courage.


"We've never been as confident as we are now," Ladan said. "We are prepared by all means to embrace the risks and walk into the operation room."


The operation will mark the first time surgeons have tried to separate adult craniopagus twins — siblings born joined at the head — since the procedure was first successfully performed in 1952. The surgery has so far only been performed on infants, whose brains can more easily recover.


An international team of 28 doctors and about 100 medical assistants will participate in the surgery.


Ladan said they would spend the hours before the operation reading the Quran and performing ritual Muslim ablutions. "We feel closer to God that way," she said.


Ladan spoke just before 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, lead neurosurgeon Dr. Keith Goh said. The pressure inside the twins' brains was more than twice what it should be.


The discovery led doctors "to believe this is something quite necessary, not cosmetic or frivolous," Goh told a news conference late Saturday.


"Rest assured, we're all here to help you. Please stay positive," Dr. Benjamin Carson, one of six international experts assisting in the surgery, told the sisters when he met them on the eve of the operation, according to a hospital statement.


The sisters each have a 50-50 chance of survival, said Carson, a Johns Hopkins neurosurgeon from Baltimore. But he said he expected the surgery to be a success.


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


The surgeons were making their own preparations ahead of the long surgery, he said: getting enough sleep and not drinking too much liquid.


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


One sister will have to have a graft to replace the shared vein, probably a vein taken from a leg, Carson said.

He compared the veins to a city's road network and said the task surgeons faced was to identify traffic jams and create detours. The largest vein was the size of a finger, he said.

Saturday's tests were aimed at finding alternative blood channels and to see if a bypass was necessary, Nair said. The tests, led by French neuroradiologist Dr. Pierre-Louis Lasjaunias, lasted four hours.

The discovery high pressure in their brains explained why Laleh had suffered chronic headaches and meant medical intervention would have eventually been necessary, Goh told reporters, without elaborating.

The twins will remain seated throughout the operation — a standard practice in brain surgery — which will last at least 48 hours and could take four days.

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.

They came to 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. But 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.

___

EDITOR'S NOTE: Ali Akbar Dareini contributed to this report from Tehran, Iran.

___
http://story.news.yahoo.com/news?tm...0030705/ap_on_re_as/singapore_conjoined_twins

Raffles Hospital: http://www.raffleshospital.com
 
Originally posted by Lasza
I cannot believe about that story. Kinda late but they get blessed. Here is the story.


Conjoined Iranian Twins, 29, Face Surgery

By D'ARCY DORAN, Associated Press Writers

SINGAPORE - A pair of 29-year-old Iranian twin sisters, joined at the head, said Saturday their fate was in God's hands as they prepared to walk into a marathon operation that could finally separate them — or could kill one or both of them.

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.


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


Sunday morning, they plan to walk into the operating room at Singapore's Raffles Hospital — rather than be put to sleep beforehand and wheeled in — as a sign of courage.


"We've never been as confident as we are now," Ladan said. "We are prepared by all means to embrace the risks and walk into the operation room."


The operation will mark the first time surgeons have tried to separate adult craniopagus twins — siblings born joined at the head — since the procedure was first successfully performed in 1952. The surgery has so far only been performed on infants, whose brains can more easily recover.


An international team of 28 doctors and about 100 medical assistants will participate in the surgery.


Ladan said they would spend the hours before the operation reading the Quran and performing ritual Muslim ablutions. "We feel closer to God that way," she said.


Ladan spoke just before 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, lead neurosurgeon Dr. Keith Goh said. The pressure inside the twins' brains was more than twice what it should be.


The discovery led doctors "to believe this is something quite necessary, not cosmetic or frivolous," Goh told a news conference late Saturday.


"Rest assured, we're all here to help you. Please stay positive," Dr. Benjamin Carson, one of six international experts assisting in the surgery, told the sisters when he met them on the eve of the operation, according to a hospital statement.


The sisters each have a 50-50 chance of survival, said Carson, a Johns Hopkins neurosurgeon from Baltimore. But he said he expected the surgery to be a success.


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


The surgeons were making their own preparations ahead of the long surgery, he said: getting enough sleep and not drinking too much liquid.


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


One sister will have to have a graft to replace the shared vein, probably a vein taken from a leg, Carson said.

He compared the veins to a city's road network and said the task surgeons faced was to identify traffic jams and create detours. The largest vein was the size of a finger, he said.

Saturday's tests were aimed at finding alternative blood channels and to see if a bypass was necessary, Nair said. The tests, led by French neuroradiologist Dr. Pierre-Louis Lasjaunias, lasted four hours.

The discovery high pressure in their brains explained why Laleh had suffered chronic headaches and meant medical intervention would have eventually been necessary, Goh told reporters, without elaborating.

The twins will remain seated throughout the operation — a standard practice in brain surgery — which will last at least 48 hours and could take four days.

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.

They came to 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. But 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.

___

EDITOR'S NOTE: Ali Akbar Dareini contributed to this report from Tehran, Iran.

___
http://story.news.yahoo.com/news?tm...0030705/ap_on_re_as/singapore_conjoined_twins

Raffles Hospital: http://www.raffleshospital.com

Hi Lasza...yeah, I heard about them going in for the marathon surgery to separate them weeks ago. There were 2 cases similar to them, but they were babies....both of them born in Brisbane, Queensland, Australia a couple of years ago and last year. One set of twins were conjoined at the tops of their heads, meaning they couldn't walk at all due to the conjoinment they had. The others were joined side by side on the backs of their heads (sort of upside down as well, hard to explain here, ha)
Both of them underwent the surgery...in 1 case, one died and one survived. The other survived the surgery, but one passed away almost a year after surgery due to unrelated infections. :( It's always hard to hear about one losing life while the other retained it. I realise it's part of taking risks to fulfill a wish to be separated rather than remaining attached to the twin for life.

Goldie
 
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wow those women are VERY brave -- they have the blessings and hope BOTH survives the surgery successfully and then be able to lead their own different lives
 
Sad news...just recieved news that one of the twins, Ladan, died on the operating table. :( The other is still in hospital in Singapore after 3 days of marathon surgery to separate her and her sister.


Twin dies in surgery
From correspondents in Singapore
July 8, 2003


IRANIAN Ladan Bijani died today shortly after a historic operation to separate her from her twin sister, hospital officials announced here.



Iranian conjoined twins Ladan (L) and Laleh Bijani / EPA

Her twin was in a critical condition.

Agence France-Presse

Goldie
 
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Originally posted by WaterRats13
Sad news...just recieved news that one of the twins, Ladan, died on the operating table. :( The other is still in hospital in Singapore after 3 days of marathon surgery to separate her and her sister.


Twin dies in surgery
From correspondents in Singapore
July 8, 2003


IRANIAN Ladan Bijani died today shortly after a historic operation to separate her from her twin sister, hospital officials announced here.



Iranian conjoined twins Ladan (L) and Laleh Bijani / EPA

Her twin was in a critical condition.

Agence France-Presse

Goldie
 

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Originally posted by WaterRats13
Sad news...just recieved news that one of the twins, Ladan, died on the operating table. :( The other is still in hospital in Singapore after 3 days of marathon surgery to separate her and her sister.


Twin dies in surgery
From correspondents in Singapore
July 8, 2003


IRANIAN Ladan Bijani died today shortly after a historic operation to separate her from her twin sister, hospital officials announced here.



Iranian conjoined twins Ladan (L) and Laleh Bijani / EPA

Her twin was in a critical condition.

Agence France-Presse

Goldie


Just in...the 2nd twin has passed away. :( Didn't make it. Oh well...sure was hoping the surgery'd be successful and give them a chance of having an individual life apart.

Goldie
 
Originally posted by WaterRats13
Sad news...just recieved news that one of the twins, Ladan, died on the operating table. :( The other is still in hospital in Singapore after 3 days of marathon surgery to separate her and her sister.


Twin dies in surgery
From correspondents in Singapore
July 8, 2003


IRANIAN Ladan Bijani died today shortly after a historic operation to separate her from her twin sister, hospital officials announced here.

Oh no, I did not heard this update news. :( I was praying for them to be survive to split their heads during operation with 28 doctors.

According to the brains are very dangerous to be separation. I can't image, they tolerate for twenty-nine years ! Itself brain is very complicated more than other part of your body. The brain is very senstive and fragile.

Subject point out: I can't image, the cochlear implant input into 18 mos old babies with fragile brain. :( That is why, I am against, small Deaf children get their cochlear implants due too risky.

Go back to this subject:

I saw them in the news last night. They walked on left side door of a car to walk inside. They do drive a car and giggle each other. Their heads were together to visual the roads.

It must be very difficult for them to share the bathroom, shower, and change clothes. Talk with their friends in privacy, etc... I assumed, they get to used do it !

They were very couregous ladies !! God bless them !

My heart goes to Ladan Bijani. They seem very friendly ladies !

~ Sabrina
 
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SINGAPORE -- A hospital worker in Singapore says the second Iranian twin has died in a surgery to separate her from her sister.

The two were born joined at the head.

Neurosurgeons finished separating 29-year-old Iranian twins joined at the head Tuesday after two days of delicate surgery, but one of the sisters died shortly after parting from her sibling.


The other twin was in critical condition and faced at least 24 hours more surgery, said hospital spokesman Dr. Prem Kumar.

"As the separation was coming to a close, a lot of blood was lost. The twins were subsequently in a critical state," he added.

Doctor were unable to stabilize the condition of Ladan Bijani and her condition worsened, he said.

Raffles hospital in Singapore announced her death minutes later.

Her sister, Laleh, was critically ill and died Tuesday.

Plastic surgeons tried to graft tissue taken from Laleh's thigh to cover her brain to protect it, Kumar said.

The risky, marathon separation procedure began about 10 p.m. EDT Saturday. Before the operation, doctors had warned that the surgery could kill one or both of the twins, or leave them brain-dead.

The brains of Ladan and Laleh Bijani were separate, but were nonetheless stuck together after years lying alongside each other.

News of Ladan's death came less than an hour after Kumar announced the twins had been separated, adding: "We should pray very hard for them."

Kumar had warned that controlling the bleeding and moving the twins from a seated position onto separate beds would be the biggest challenge, and that the condition of either twin would remain largely unknown until they wake up after surgery. The twins were seated during the operation.

The team of doctors had to contend with unstable pressure levels inside the twins' brains just before they worked to uncouple the sisters' brains and cut through the last bit of skull joining them, Kumar said.

On Monday, the team of doctors completed one of the most dangerous steps in the surgery by rerouting a shared vein and stitching in a new one. The shared vein, thick as a finger, drained blood from the twins' brains to their hearts.

The sisters' brains had "to be teased apart very slowly," Kumar said. "Cut. Teased apart. Cut. Teased apart. In the process, you encounter a lot of blood vessels and other tissues."

He said surgeon worked "millimeter by millimeter."

The operation was complicated further when the team discovered that the pressure in the twins' brains and circulatory system was fluctuating.

Dr. Marc Mayberg, chairman of neurosurgery at the Cleveland Clinic in Ohio, had said by telephone the pressure fluctuations could be fatal.

Monday's rerouting the shared vein was considered one of the biggest obstacles in the surgery. German doctors told the twins in 1996 that the surgery was too dangerous, but the Singapore team benefited from technological advances, Kumar said.

Although the sisters knew the operation could kill one or both of them, they decided to face those dangers after a lifetime of living conjoined and compromising on everything from when to wake up to what career to pursue.

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

An international team of 28 doctors and about 100 medical assistants were enlisted for the surgery. The Iranian government said Monday it would pay the nearly $300,000 cost of the operation and care for the twins.

This is the first time surgeons have tried to separate adult craniopagus twins -- siblings born joined at the head. The surgery has been performed successfully since 1952 on infants, whose brains can more easily recover.

Participating neurosurgeon Dr. Benjamin Carson, director of pediatric neurosurgery at Johns Hopkins Children's Center in Baltimore, has separated three sets of craniopagus twins.

Because this operation is a medical first, surgeons have encountered unexpected obstacles not seen in infants. It took longer to cut through portions of their skulls because their older bones were denser than previously believed, Kumar said.

As the procedure dragged on, surgeons tried to get adequate rest, slipping out of the operating room for breaks when their expertise was not needed, Kumar said.

Classical music played softly as surgeons worked simultaneously in tight spaces in front of and behind the twins, who sat in a custom-built brace connected to an array of lines feeding them intravenously and monitoring their vital signs, Kumar said.

The sisters were born into a poor family of 11 children in Firouzabad, southern Iran, but grew up in Tehran under doctors' care.
 
http://news.bbc.co.uk/2/hi/asia-pacific/3053386.stm

You will see the graphic picture of the brains in that site.

There is explaining why they died due to blood flow when they cut their brain split within 17 hours. It was really slow to cut but the blood flow beat. :(

If they do this such younger with more soft bone. It may have a little good chance. Now their bone grow much older and difficult to operation them.

Laleh told the report last month. As girls they used to cheat on tests by whispering answers to each other.

The government caught on and concluded it would be nearly impossible for them to compete individually in university entrance exams, so it granted them a scholarship to study law at Tehran University.

After surgery, the twins hope to move back to Iran and live together while Laleh pursues journalism and Ladan works as a lawyer, said Bahar Niko, 24, a teacher who befriended the sisters in Singapore.


~ Sabrina

Dear Friends,

Thank you for all your good wishes and kind thoughts.

We are touched by all the cards and email pouring in every day from people all over the world.

Your kind gestures have brought much comfort to us as we anxiously wait for surgery next week.

We have been praying every day for our operation. We are excited about it as we've waited 28 years for it!

Please pray for us, for Operation Hope to be successful.

Both of us have started on this journey together and we hope that the operation will finally bring us to the end of this difficult path and may we begin our new and wonderful lives as two separate persons.

May God bless you all,

Laleh and Ladan Bijani
 
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What 'bout the orginal siamase twins? did they ever get separated?
 
Originally posted by Steel
What 'bout the orginal siamase twins? did they ever get separated?

I found the link about the information that help answer your question. Wanna more information?
Here is the link http://news.bbc.co.uk/2/hi/health/994130.stm


" There have only been 30 attempts world-wide between 1928 and 1987 to separate head-joined Siamese twins.

Only 26 of the 60 twins survived these procedures. "


I do believe there are more and more after 1987. Not know how many really total from 1928 to now. :dunno:
 
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These women sure were brave enough to take the risks n go under the knife. My heart goes out to them.
 
AWWWW Im so sorry for this! at least thier with thier God now, and not in pain anymore, or suffering and they truly was brave for doing this....
 
my heart goes out to them upon their deaths -- Laleh and Ladan are the adult pioneers in medicine for conjoined twins, were so brave knowing the risks and in the end gave their lives but in the process has also taught the doctors worldwide something new about adult conjoined twins in their process of separating them -- they are now in the hands of God and been blessed by all worldwide

God bless
 
many Iranians are upset about this cuz this was one of our own. it is so sad, but we all knew that it was going to happen that they may not survive, they knew the risks but it is too bad it was not successful.
 
boy, i did got exciting when i hear about that few days ago, but now sadly they died. RIP iran gals. you sure are VERY BRAVE ladies!
 
Iranian twins die after operation fails

Doctor Loo Choon Yong, chairman of Raffles Hospital, in a news conference in Singapore, says everyone knew it might end this way.




AFP - The historic attempt to separate adult Iranian twin sisters joined at the head ended tragically when Ladan and Laleh Bijani died within 90 minutes of each other after a marathon operation.

"Raffles Hospital regrets to announce that the Bijani twins, Ladan and Laleh, have both passed away during surgery to separate them," a hospital statement said, sparking widespread mourning in their homeland.

Doctors told a news conference afterwards that the twins lost too much blood as the neurosurgical stage of the 52-hour operation, in which their tightly enmeshed brains were separated, was coming to an end.

"It was very disappointing for us that the blood loss was so tremendous in the final stages. This occurred mainly after they were separated," Singapore neurosurgeon Keith Goh, who led the medical team, told reporters.

Goh said the operation was much more complex than expected because, although the twins had individual brains, the blood flow through them was too closely intertwined.

"What we have begun to understand in this case... are that the patterns of blood flow through such abnormally joined brains is hard to predict," he said.

The hospital had earlier in the afternoon triggered hope the 29-year-old sisters would survive the operation when it announced that the neurosurgeons had successfully separated their heads.

But hospital spokesman Prem Kumar Nair returned shortly afterwards to announce the Ladan had succumbed to massive blood loss.

Despite blood transfusions and other efforts to save Laleh, she died after her blood circulation also failed.

Goh and his team of 24 doctors and about 100 medical staff began the world-first operation knowing that one or both of the sisters might die.

German doctors refused Ladan and Laleh's plea in 1996 to operate, warning the operation would most likely kill one or both of them, or leave them in a vegetative state.

Since similar operations began 50 years ago, four in five attempts at separation have resulted in death or severe complications for one or both of the twins.

The Bijani sisters faced a greater risk as they grew older, with all previous operations to separate conjoined twins taking place when the patients had yet to reach adulthood.

Goh and other doctors involved in the surgery denied they had made the wrong decision in succumbing to the twins' relentless determination to be separated.

"I think that the debate, the argument and the controversies will go on forever and ever," Goh said.

"But I think that for those of us who were over the last three days, the time and the commitment... is a convincing indication of the belief that the decision was correct."

The executive chairman of the Raffles Medical Group that runs the hospital, Loo Choon Yong, revealed the medical team had considered abandoning the operation on Monday evening when it became clear an attempt to graft a vein from Ladan's thigh into her head may not work.

But they decided to press on after again being reminded by the twins' relatives and friends in Singapore of their "wish to be separated under all circumstances".

Ladan, generally recognised as the more feisty of the sisters, gave the world a glimpse of their unshakeable commitment during a press conference last month in Singapore.

"We don't have any fear about the surgery," Ladan said.

"We feel happy, excited and a little bit nervous, especially me."

Laleh said she and her sister, both qualified lawyers, realised the dangers of the surgery but were focused only on a successful outcome.

"We believe God will help us. We go to the gym every day to do exercises and we think positively. Mentally we must think positively," Laleh said.

Although Raffles Hospital officials had remained publicly optimistic throughout the surgery, an ultimately fatal series of complications and delays plagued the operation.

Doctors encountered a six-hour delay on the first day when they realised while removing a strip of bone that connected the women's heads that their skulls were thicker and more dense than initially believed.

Further complications arose on Monday when surgeons discovered the sisters' brains were more closely linked than previously thought, followed by the problems with their blood pressure.

The fate of the twins was closely monitored in their homeland, with millions of Iranians absorbing the minute-by-minute updates provided on state-run television and radio.

"These last 29 years, from the announcement of their birth to the different moments in their painful lives, have now been engraved in the collective memory of the country," Vice President Mohammad-Ali Abtahi told AFP.

"Not only the family of Laleh and Ladan, but all the Iranian people have been closely following this operation. Their deaths makes us all distraught."


©AAP 2003

God bless them. They're in peace.

Goldie
 
Goldie,

Wow, that article is very beautiful. I was tearing my eyes when I read it. I can't image how could both of them survive for twenty-nine years to share to riding the bike, drive a car, dance, walking, sharing bed, bathroom, shower, etc...

Wish, there is a better technology to have a laser to keep the vessel or skin coverage to prevent blood loss. The vessel and skin coverage immediately with laser.

Just like a movie when E.T. laser the finger at the little boy to heal/recovery quickly !

I saw them on the ABC world news last night. Wow, they were so friendly with beautiful smile. They rode the bike and share in a car to drive. Wow, it is so amazed !

I am very surprise, they had their low profile all those years. I never heard of their names until now.

~ Sabrina
 
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