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. 2009 Jun;53(3):294-301.

Anaesthetic management of conjoined twins' separation surgery

Kolli S Chalam  1
Affiliations

Anaesthetic management of conjoined twins' separation surgery

Kolli S Chalam. Indian J Anaesth. 2009 Jun.

Abstract

Anaesthesia for conjoined twins, either for separation surgery, or for MRI or other evaluation procedures is an enormous challenge to the paediatric anaesthesiologist. This is an extra challenging surgery because we the anaesthesiologists need to care for two patients at the same time instead of just one. Anaesthesia for conjoined twins 'separation surgery mainly centered on the following concerns: 1.Conjoined Twins' physiology like crossed circulation, distribution of blood volume and organ sharing with their anaesthetic implications. 2.Long marathon surgery with massive fluid shifts and loss of blood & blood components and their rapid replenishment. 3.Meticulous planning for organized management of long hours of anaesthetic administration in two paediatric subjects simultaneously with multi surgical specialties' involvement and their unique requirements. We report the anaesthetic and intensive care management of one pair of Pygopagus separation surgery and also the review of literature and world statistics.

Keywords: Anaesthesia; Conjoined twins; Monitoring; Separation surgery.

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Figures

Fig 1
Fig 1
Pygopagus conjoint Twins
Fig 2
Fig 2
Computerized 3 D model of Pelvis.
Fig 3(a, b)
Fig 3(a, b)
Intra-operative pictures
Fig 4
Fig 4
Separated twins moving freely
See this image and copyright information in PMC

References

    1. Hansen J. Incidence of conjoined twins. Lancet. 1975;306:1257. - PubMed
    1. Potter EL. Pathology of the fetus and the newborn. Chicago: Yearbook Medical Publishing; 1952. pp. 172–98.
    1. Willis RA. The border land of embryology and pathology. 2nd edn. London: Butterworth's; 1962. pp. 135–47.
    1. Beckwith JB. Conjoined twins: developmental malformations and clinical implications. Pediatr Dev Pathol. 2003;6:361–4. - PubMed
    1. James L Stone, James T Goodrich. The cranlopagus malformation: classification and implications for surgical separation. Brain. 2006;129:1084–1095. - PubMed