Polish conjoined twins, 14-month-old, were successfully separated on January 3^rd and they were safe and sound after a ten-stage operation lasting 15 hours at the King Abdul Aziz Medical City for the National Guard in Riyadh.

The surgery commenced as scheduled at 7.30 a.m. when Dr. Mohammed Elgammal Anesthesiologist; anesthetized twin 1 initially followed by twin 2 without any complications. By noon, the surgeons -a 25- member surgical team headed by the Chief Executive Officer (CEO) of the hospital, Dr. Abdullah Al-Rabeeah, had successfully completed three phases of the operation by dissecting the intestines, anus and urological system. Separation of the spinal cord which began at 4.30 p.m. took four hours to be completed. The surgery ended 15 minutes ahead of schedule to the loud applause of the twins' mother and the medical team present. The twins were born on Oct. 8, 2003 to a seamstress mother in Poland. They were brought to kingdom of Saudi Arabia after Crown Prince Abdullah agreed to a request by their mother to have separation surgery. This delicate surgery was the ninth of its kind at the hospital.

The mother reported to be tense at the commencement of the surgery and a special attendant was present to console her and keep her comfortable throughout the surgical process. She prayed and kissed her children before the doctors got down to their task. Polish pediatrician Dr. Jolanta Jezewska, supported by the diplomatic staff of the Polish Embassy including Ambassador Adam Kulach and his wife Olga Kulach, were kept on tenterhooks till the babies came out of the operation theater. “The day of separation of the twins is the happiest event in my life. I am optimistic of the results of the surgery,” Dabrowska told reporters. The mother get relaxed as the operation progressed without a hitch through its various phases. Prior to the surgery, Dr. Rabeaah indicated to the mother that clinical and neurological examinations showed weakness in the muscles and nerves supplying anal and sphincter, pelvic floor and lower limbs, especially the right leg of twin 1. Dabrowska agreed to proceed with the surgery acknowledging the potential risks.

The twins, who arrived in the Kingdom on Dec. 12, 2004, underwent a course of preoperative tests for a fortnight to confirm a safe separation of the babies.

The twins were joined at the abdomen, pelvis, buttocks and spine. They shared one anal canal and rectum with adherence of their lower urinary and genital systems. Twin 1 had a complete urinary and genital system whereas twin 2 had a single abnormal kidney with complete remaining urinary and genital system. There was a union of lower aorta (major artery of the abdomen) and vena cava (major vein of the abdomen) and also shared a common lower spinal (I cord) with possible overlap of the nerves supplying the pelvis and lower limbs.

On Feb 8^th 2005, The Polish community in the Kingdom has honored Dr. Abdullah Al-Rabeeah and his team for the successful operation to separate conjoined twins [₂].

Polish Ambassador Adam Kulach hosted a special reception at his residence on Wednesday to honor Dr. Rabeeah, executive director of the King Abdul Aziz Medical City for the National Guard. The envoy presented a special memento to Dr. Rabeeah and certificates of appreciation to all the members of his medical team. The function attended by members of the diplomatic corps, the Polish community and high-ranking government officials. US Ambassador James C. Oberwetter and British Ambassador Sherard Cowper-Coles were also present. On behalf of the Poles, the mother of the twins, and her accompanying Polish pediatrician, Dr. Jolanta Jezewska, presented rare paintings to Dr. Rabeeah in appreciation of his contributions to the surgery.

Since 1990, nine surgeries for separation of conjoined twins have been performed in the Kingdom. Three pairs of twins were from the Kingdom, two from Sudan and one each from Malaysia, Egypt and the Philippines. The last one was early last year when doctors successfully separated eight-month-old Filipino conjoined twin girls who shared an abdomen, pelvis and lower organs.

Pictures 1 & 2 are curtsey of KFNGH public relation press releases, while Picture 3 is curtsey of Alriyadh News

Figure 1

Picture 1: The twins before separation.

Figure 2

Picture 2: Dr Elgammal give anesthesia.

Figure 3

Picture 3: Dr Rabeeah with the family after discharge. [Alriyadh News (}]