First separated New Year for Odisha conjoined twins

30 Dec 2017

Having battled the impossible, Jaga and Kalia, the conjoined twins from Odisha's Kandhamal, will for the first time usher in a New Year separately, albeit from a hospital ward. It's been two months and five days since the twins, who were joined in the head, underwent a marathon 21-hour-long separation surgery after which their lives hung in balance for almost a month.
While Jaga kept showing a steady progress, Kalia's road to recovery has rather been a bumpy ride with his condition deteriorating on quite a few occasions to the extent that his survival seemed difficult. But the steely determination of the doctors and the unflinching faith of the parents bore results and Kalia is off ventilator now for the last three weeks.
Dr Randeep Guleria, Director of the All India Institute of Medical Sciences (AIIMS), Delhi where the surgery was carried out, said Kalia is also showing improvement now. "He is being fed via ryles tube and is also accepting liquids orally in small amount. He often smiles at parents and probably understands things too," Dr Guleria said. While the children battled death and conquered it, life has been equally challenging for their parents, who turned almost permanent residents at AIIMS since July 14 so as not to miss any opportunity to be with their recuperating sons.
"Jaga and Kalia are the two halves of my heart. If either of them breaks, my heart would be shattered," said Pushpanjali Kanhar, mother of the two-years-eight-month old twins. "It is my faith that they will soon be fine and we all shall return to our village Milipada in Odisha," she said.
Dr Deepak Gupta, professor of neurosurgery at AIIMS, said that Jaga is on a normal diet comprising eggs and bananas and interacting well with parents. "He is also able to stand and walk with support," Dr Gupta said. Recalling the crucial moments of the surgery, Dr Gupta, who played a key role in the operation, said Jaga suffered a cardiac arrest when he was separated from his twin brother. A team of anesthetists including Dr Sandeep Chauhan and Dr Girija Rath resuscitated the child and almost after half- and-hour, Jaga's heart started beating again. "They received autalogus blood transfusion, which means whatever blood we were losing the same blood was collected in a cell saver and was transfused back to the children," Dr Gupta said. However, the brains of the twins weigh a little less than the normal.
"Generally the brain of the children of this age weighs around 700-800 gram but after separation Jaga and Kalia, who earlier shared the same brain, each of their brains now weigh around 400-500 gram," Dr A K Mahapatra, the neurosciences chief at AIIMS, said. The children recently underwent skin grafting procedure to cover the exposed wound on the head using skin from their thighs. This was India's first craniopagus surgery to separate twins who were joined from their heads, according to experts.
The first phase of the surgery was performed on August 28 when the doctors created a venous bypass to separate the veins shared by the babies that return blood to the heart from the brain. The final separation of the duo was performed by a team of around 30 specialists from the institute's neurosurgery, neuro-anaesthesia and plastic surgery departments on October 25. Dr Gupta had earlier said the condition, which the twins suffered from, afflicted one in 30 lakh children, of which 50 per cent die either at birth or within 24 hours. (PTI)