KNH doctors separate conjoined twins in 23-hour surgery

Surgeons at Kenyatta National Hospital (KNH) have successfully separated conjoined twins in a 23-hour operation.

The girls, named Blessing and Favour, were born in September 2014.

The surgery, which ended in the wee hours of Wednesday, took two years of meticulous planning due to the complex nature of the areas shared by the twins. The girls were joined at the lower back.

The complicated procedure, which began on Tuesday, involved a team of 58 professionals. Acting KNH CEO Thomas Mutie said this was the most complex procedure to be done successfully in sub-Saharan Africa apart from South Africa.

"I am humbled by the success and importance of this event. The twins were born in Meru and referred to KNH where they were admitted to the surgical unit," said Dr Mutie.

Mutie said he visited the twins in the morning and they were doing well.

The surgical team was led by paediatric surgeon Fred Kambuni. Dr Kambuni said due to the manner in which the twins were conjoined, various teams had to work together to ensure the separation was successful.

"The two girls were born through normal delivery and it was realised they were conjoined. When they were brought here, we studied them for a whole year - we had planning meetings and looked at images, including three dimensional prints," said Kambuni.

Surgery began first on paper before it was actualised, the doctor said. The procedure will be followed by rehabilitation until the twins get well. This is expected to take another year.

The whole process was slowed down by the realisation that the girls, who were joined mainly on the lower end, shared some vital parts of the body. For instance, they had different guts up to the rectum but shared the anus and genitals.

Utmost care

"There will be reconstruction of these shared areas," Kambuni said.

Nimrod Mwangombe, the head of neurosurgery at University of Nairobi (UoN) and who was part of the team, said the back area and the urogenital system were stuck and required a lot of precision and utmost care.

"Now that the separation has been done, plastic surgeons will come in to restore the areas that were operated on," said Prof Mwangombe.

This is not the first case of conjoined twins that KNH has handled. However, according to Kambuni, it is the most complex but successful case.

"Others came but they were complex mainly because there were shared organs. In other cases, one of the twins has been a parasite such that even separating them would be difficult," explained Kambuni.

With the children spending about 700 days at the hospital, accommodation alone would have cost Sh10.5 million. Equipment would have cost Sh25 million while professional charges would have amounted to about Sh70 million.

The bill will be paid by KNH and the National Hospital Insurance Fund.

Journalists highlighted the girls' case on August 4, 2014, and they were transferred to KNH.