Two 8-hour long rehearsals on polylactic acid model saved craniopagus twins at AIIMS

As the craniopagus twins from Orissa, who went through one of the rarest surgeries in the country in October, recovered from the major operation and are ready to go home by the end of February after the last round of surgery, doctors share details on how the complex procedure was performed.

A polylactic acid model was created on which a team of doctors from the All India Institute of Medical Sciences (AIIMS) ran two eight-hour-long dry rehearsals in the operation theatre followed by a 24-hour-long marathon operation to make sure that everything ran smoothly. This was the first time in the country that a 3D model was used for practice.

The polylactic acid model was based on the information from the MRI, CT-Scan, and Angiogram of the twins and resembled their head structures. In the 24-hour-long operation, first, a 'venous bypass' was done, followed by a 19-hour-long surgery to separate the kids. "This model helped us as we knew precisely which parts had to be operated upon and where to put incisions. The model had Jagga and Balia marked on the heads for us to know," said Dr Deepak Gupta, Pediatric Neurosurgeon, AIIMS.

The 3D model was imported from New York for $4,000 and two other smaller models were brought in from Bangalore.

A team of 125 medical professionals from the AIIMS was involved were involved in the operation, including 50 paramedical staff and 75 doctors from all departments. The operation was jointly headed by Dr AK Mahapatra, Chief of Neurosciences Centre, AIIMS and Dr Deepak Gupta .

Almost 100 days after the surgery, both the kids are now recovering. While several head graftings (transplants) have been performed on them, the twins still miss skull bones and have to undergo the last round of surgery. Currently, they are on soft food diet and weigh 10.9 kgs and 11.1 kgs each.

FACTS OF THE CASE

• Three such surgeries have been performed earlier in the country. First in 1994 in Kerela, where both the kids died.
   
• Then in 2003, where Dr Murlidhar Pai, Neurosurgeon from Manipal, operated on two kids, where one girl is still alive.
   
• The last attempt was in 2013 in Guhawati, where again both the kids died.
   
• Worldwide only 15 kids who were born craniopagus are still alive.