Surgery still four months away for twins

Eva C. Komandjaja, The Jakarta Post, Jakarta

A team of 25 specialists at Cipto Mangunkusumo General Hospital (RSCM), Central Jakarta, announced on Tuesday that they would wait until the conjoined twins, Anggi and Anjeli, were five months old before performing an operation to separate them.

Head of the medical team Arwin P. Akib said the team needed to examine the twins more thoroughly and also needed to wait until their condition stabilized before attempting the surgery.

"This kind of surgery must not be rushed. We must be sure that both babies are going to survive, so we need to conduct more examinations," he said.

Hospital records show that previous surgeries to separate conjoined twins were performed when the infants were between four to six months old. Anggi and Anjeli were only 28 days old as of Tuesday.

As the chance for both babies to survive the operation is slim, the team has decided to postpone the procedure.

Arwin said the babies would need to stay at the RSCM for the next four months to monitor their conditions, as even minor illnesses such as coughs or runny noses would be destabilizing.

So far, the twins have not gained weight since they were admitted to the hospital, and only weigh 4.8 kilograms together.

Arwin said medical examinations for the twins would take a long time, as only one examination could be conducted in one day because of their fragile condition.

"We have to realize that the twins are very young and they have physical defects. We must be really careful in conducting the examinations," said Idham Amir, head of the Perinatal Care unit, where Anggi and Anjeli are being treated.

The twins have only one leg each and share a third in the middle of their bodies. It is likely that doctors will remove it during the surgery.

Doctors have found that the twins' excretory systems -- both urinary and intestinal -- are abnormal: Each baby has only one kidney and they share one anus, while their small intestines are joined together.

In addition, Anggi's heart, while it is functioning normally, is located on the right-hand side of her body.

Unfortunately, Anjeli's heart, which is positioned normally on the left. is abnormal, including leaking heart valves.

"There are openings in Anjeli's ventricles and she suffers from cardiac abnormalities. Once she is separated from her sister, we must perform heart surgery on her," Arwin said.

The doctors have not yet examined the twins' reproductive systems, but it is feared that they may be abnormal as well.

The hospital has performed four surgeries to separate conjoined twins with similar conditions, but those twins had four legs between them, unlike Anggi and Anjeli.