INFAN twins Nima and Dawa have entered the operating room this morning to undergo a separation operation at Royal Children 's Hospital in Melbourne.
It is not clear how long the Siamese twins from Bhutan will remain in the operating room to separate their bodies. Although there are many plans from the pediatric team and scans of their bodies that are 15 months old, it remains unclear which body parts are shared by the girls.
Doctors have determined they are connected to the torso and they share the heart. Girls also have intestines that must be "divided" but say they can be separated or shared.
The trip of the twins to Australia was rather horrible. Their mother, Bhumchu Zhangmo, traveled with them with a terrible 26 hour transit, including a difficult stopover in Bangkok.
On Friday, the head of pediatric surgery Dr. Joe Crameri, who led the team of 18 which included surgeons, anesthesiologists and nurses, said: "We continue to make guesses about how long this will last, but the reality is until the operation begins and we can finally see what connects girls, we won't know how long.
"We knew that the intestine was mixed and that it could be completely separate and sit next to each other or that girls could share their intestines and we had to find a way to divide it.
"The only benefit we have is that we are all born with lots of intestines and you can reduce that."
The difficulty with surgery in conjoined twins is anesthesia and the different effects that drugs can have on the twins, because they share the body. The twins have shared circulation and before surgery their condition is described as "fragile".
"One of the complexities is that you really don't know what you are doing to a twin, how that affects others," Dr. Crameri added.
The twins and their mothers are from the Himalayan country of Bhutan, a country famous for its mountains, peace and government which instituted a plan to govern "Gross National Happiness".
Upon arriving in Australia, Dr. Crameri said he was pleased with the presentation of Nima and Dawa last month.
"I am convinced that the twins are active and interact with each other, and I am happy to see mothers feed the girls well," he said.
Their mother, Mrs. Zhangmo was excited and wanted the surgery to be finished.
"These little girls are very special because if we don't do this operation … we only care if they will live," said CEO of the First Children Foundation, Elizabeth Lodge.
He has encouraged the community to contribute to the after care and rehabilitation of Nima and Dawa, which will take place at the 24-hour Children First Foundation facility on a farm in Kilmore, Victoria.
"We have a team of physiotherapists working with us pro bono, which is amazing … so we will make them crawl and roll over and hit all the signs that are most likely to be done by 14-month-old girls now," he said. The Sydney Morning Herald.
"We will have some of the same surgeons, anesthesiologists, theater staff, we will have the ICU team back with us again, so we are very sure these little girls will be successfully separated and soon be able to crawl, roll over, jump and run as two small independents. "
The $ 350,000 surgery is expected to be borne by the Government of the State of Victoria.
HERE HOW CAN YOU HELP NIMA AND DAWA:
1: Donate by telephone at toll free 1800 99 22 99
2: TWIN text to 0437 371 371 for making online donations
3: Visit childrenfirstfoundation.org.au/donate and choose Twins18 as the campaign name
4: Donate via electronic transfer through your online banking system to the account details below.
Bank: Bendigo Bank
Name: First Foundation Child (CFF Prize Account)
Account number: 163045552
Reference: Enter your full name and "twin"
To receive a tax receipt for donations made through electronic transfers, please send an email to [email protected] with transaction details.