Doctors separate conjoined twins

? Two-year-old Egyptian twins joined at the top of their heads were successfully separated Sunday, but they face a long recovery after the marathon surgery that began a day earlier and took more than a year of planning.

News of the successful separation of Ahmed and Mohamed Ibrahim overjoyed their parents, surgeons and caregivers.

“At one point when someone came up and said you have two boys, the father jumped to my neck and he hugged me and he fainted and I cared for him. He told me that he never dreamt of such a moment,” said Dr. Nasser Abdel Al, who was one of the twins’ doctors in Egypt and was with the family in Dallas.

“The mother, on the other hand, was crying like everybody else. She was there thanking everybody around and thanking her faith that brought her to this great place — Dallas, Texas.”

As surgeons worked to finish closing the boys’ head wounds, part of the medical team talked Sunday about the successful completion of the surgery at Children’s Medical Center Dallas.

Ahmed and Mohamed, who had an intricate connection of blood vessels but separate brains, were physically separated about 26 hours after they entered the operating room. Doctors then went to work covering the head wounds. The entire surgery took 34 hours.

The twins were listed in critical but stable condition, and doctors said the surgery went according to plan. Concerns now include risk of infection and how the wounds will heal.

Dr. Kenneth Salyer, a craniofacial surgeon who founded the World Craniofacial Foundation that brought the boys to Dallas, said his feelings had ranged “from moments of ecstasy to moments of anxiety.”

Dr. Dale Swift, a pediatric neurosurgeon, said it was too early to tell if the boys would have neurological damage. He said the boys’ post-surgical care will be vital to their recovery.

Mohamed and Ahmed Ibrahim, 2, are shown in this May 25 file photo. The conjoined twins were successfully separated Sunday after a 26-hour surgery.

After leaving the operating room, the boys were taken to an intensive care unit, where they will remain in a drug-induced coma for three to five days. Both boys will need additional reconstructive surgery in coming years.

The boys were born June 2, 2001, by Caesarean section to Sabah Abu el-Wafa and her husband, Ibrahim Mohammed Ibrahim. Both parents, from el-Homr, some 400 miles south of Cairo, were in Dallas for the surgery.

A team of specialists determined in June 2002 that the boys could be separated, though the risks included possible brain damage and death. The boys’ father told doctors he felt it was worth it to give them a chance at a normal life.

On Saturday, 4-month-old twin girls from Greece who were joined at the temple were successfully separated during surgery in Rome. The ANSA news agency said the 12-hour surgery was simplified because the infants didn’t share any organs.

Prior to the operations in Rome and Dallas, there had been at least five surgeries around the globe in the past three years to separate twins joined at the head. Three were successful; one resulted in one twin dying and in another both twins died.