Separated twins remain 'serious but stable'

A New Zealand surgeon who helped separate conjoined twins in Melbourne, in one of the world's most complex operations, said none of the complications they had allowed for had materialised.

Separated conjoined twins Trishna and Krishna remained in a serious but stable condition in Melbourne on Wednesday.

A spokeswoman for Melbourne's Royal Children's Hospital said the girls' condition had not changed overnight and they remain in a serious but stable condition and connected to ventilators.

Associate Professor Leo Donnan said there was currently no evidence the girls suffered any brain damage.

But he said apart from the risk of infection, the girls' bodies needed to adjust to operating independently.

"They both will have issues with their kidneys and with other organs as well," he said.

"There is a whole lot of changes that will occur over the next couple of weeks, even into months, and we really don't know how well they will tolerate those."

The head of the charity that brought conjoined twins Krishna and Trishna to Melbourne for surgery has described the sight of the girls in separate beds as "beautiful".

"To see them in two little cots - I can't tell you what it looks like," Margaret Smith, chief executive of the Children First Foundation, told Australian Radio 3AW this morning.

"After seeing them in a V-shape as we're used to seeing them and now they're not, they're separate. These two little long bodies in the bed. It's just magnificent."

KIWI SURGEON

Andrew Greensmith, a plastic and maxillofacial surgeon, said he was holding the heads of the Bangladeshi twins, who were joined at the head, at the final moment of separation by the neurosurgeons.

He said in the final moments of surgery, after nearly 30 hours, the neurosurgeons asked him to move the heads slightly apart.

"We took the brakes off the beds in the operating theatre and literally, millimetre by millimetre, started to push the beds apart," he told NewstalkZB.

"We were just checking they had no final little strands of blood vessels or tissue. We didn't want to move quickly and tear anything."

He said by then, after nearly 30 hours, the connections between the two girls were "down to a few gossamer-type, flimsy strands, some of them small blood vessels, remaining little pieces of tissue.

"We had most of it cleared before we even started to dare try to move the heads apart."

He said there were areas they found which could not be seen or predicted in the preparation for surgery and they had to be dealt with during the marathon operation.

He said that included two areas of brain which they originally thought might be a "button" but which were joined and had to be separated.

He said the operation all went very smoothly.

"There were no scares whatsoever throughout the operation. We were prepared for potentially catastrophic things happening at some point, major bleeding which we may have trouble stopping, all sorts of possibilities.

"But we had none of that at all. It was really just painstaking work."

Dr Greensmith said he was able to get away for a couple of two-hour "power naps" during the operation, but the neurosurgeons, including New Zealander Alison Wray, went the entire distance without a break.

"It was remarkable, they didn't get short with anyone, they were fantastic, just completely in the zone and focused the whole way."

He said he continued to work on one of the girls as the other was wheeled out of the operating theatre.

"It was quite bizarre to see them apart for a change ... quite surreal."

The surgery at the Melbourne's Royal Children's Hospital ended yesterday afternoon and the twins were likely to be kept in a coma for another day or two.

The complex surgery ended two years of planning for the girls, now aged two years and 11 months.

The girls were left in an orphanage soon after their birth and two Australian volunteers, Danielle Noble and Natalie Silcock, realised their plight.

They began fundraising with Atom Rahman from the Children First Foundation and the girls were taken to Australia for the operation.

- NZPA