The Siamese sisters who were separated last week at the Sant Joan de Déu hospital in Barcelona are in perfect condition, they will be able to live a completely normal life and at the beginning of next week they will be transferred to their country of origin, Mauritania .
The Mauritanian Minister of Health, Naha Mint Hamdi Uld Muknas, traveled to Barcelona to thank the hospital and the medical and surgical teams for the attention given to the twins Khadija and Cherive, who were born on October 8th united by liver, with a single umbilical cord and a combined weight of 5.2 kilos.
The first Siamese separation operation that has been carried out in Sant Joan de Déu - the second in Barcelona after the one carried out in Vall d'Hebron just over ten years ago - went optimally, according to the boss of surgery, Xavier Tarrado. It lasted five hours including the anaesthesia, a team of more than twenty people participated and none of the predicted incidents were recorded in a very detailed prior simulation of the intervention.
“Each girl had her liver, the only viscera they shared, but the livers were fused in the middle. The main possible complications were bleeding and bile leakage, but they did not take place", explained Tarrado. The second part of the intervention, which consisted of the closure of the abdominal wall of both girls, also developed optimally, without the need to use prosthetic material.
The patients progressed very well. A few hours after the surgery, mechanical ventilation could be removed and they started feeding relatively soon, according to Ana Alarcón, head of the neonatology service. The two girls have been at the hospital since Tuesday, in the care of the relatives who accompanied them, the mother and an uncle. "We see the family in perfect condition to take care of them. We are coordinating the follow-up in your country, which we think will be simple; we don't think they require our intervention", explained the doctor.
Alarcón was part of the mission that at the end of October transported the sisters on a 4-hour flight from the Air Force's air evacuation unit from Nouakchott. The plane picked up the sisters from an ambulance at the foot of the runway, in the presence of the Mauritanian Minister of Health. The mother and uncle had flown the day before to receive them in Barcelona.
Planning the surgery was key. The team of José María Quintillá, head of simulation and 3D printing at the hospital, did an extraordinary job to build a training ground faithfully reproducing the scenario that the surgeons would encounter, with mannequins in an anatomical position identical to that of the patients. “We found 50 specific facts that needed to be taken into account on the day of surgery and that we were able to anticipate. We were able to define in time each of the gestures that had to be done that day", stated Quintillá. This planning made it easier for the surgeons to anticipate the possible situations they might encounter, according to Tarrado: "It made it possible to reduce the time of the surgery and to do it more safely. In the simulation, we did several critical situation scenarios".
The case came to light as a result of a hospital cooperation agreement for the digital transformation of primary care in Mauritania and was financed through the Cuida't solidarity program.