I am very proud to work at King Saud bin Abdulaziz University for Health Sciences which is also part of the National Guard Health Affairs (NGHA). For those who are not aware, NGHA is known worldwide for its efforts of separating Siamese twins. The majority of these separations are performed by His Excellency Dr. Abdullah Al Rabeeah, who is both an orthopedic surgeon and Chief Executive Officer of NGHA. And furthermore, these complex separations performed on Siamese twins who come to NGHA from all over the world are performed as humanitarian acts with no costs to the families.
Presently about 15 sets of conjoined twins have been successfully separated. It is very exciting when such a surgery occurs and often employees of NGHA can view parts of the actual surgery taking place via closed circuit tv.
So exactly what does it mean when someone makes reference to Siamese twins? While there are dozens of types of conjoined twins, doctors generally divide the types into more common variations such as:
Craniopagus: Dorsal or rear union at the head. Separation is possible but brain damage is common.
Rachipagus: Dorsal or rear union at the spine. Very rare incidence.
Parapagus: Lateral or side union with variety with third and fourth limbs. Separation is possible although a life with artificial limbs is the result.
Pyopagus: Dorsal or rear union at pelvis. The incidence of these twins is rare but the survival and outlook is good.
Cephalopagus: Ventral or frontal union including the head and chest. The two faces on the opposite side of the head characterize the union. These twins do not survive.
Ischiopagus: Ventral or frontal union at the pelvis often with shared intestines, bladders, genitals
and kidneys. Separation survival rate is good although excretion and sexual functions can be impaired.
Omphalopagus: Ventral or frontal union at the abdomen. Often with shared liver tissue. This type of twins has the highest survival rate. Liver tissue is the only body organ that can regenerate itself, making separation of the liver possible.
Thoracopagus: Ventral or front union at the chest, often with a shared heart. This type of twins does not survive, although separation has been attempted.
Parasitic: Additional limbs or torsos or heads, believed to be caused by the death of one twin in utero.
The above information was collected from http://www.conjoinedtwinsint.com/facts.html
According to undated information from NGHA on the incidence of conjoined twins in Saudi Arabia there have been 19 cases as compared to other countries in the region and with these twins seen at NGHA:
Sudan – 6
Yemen – 2
Egypt – 2
Malaysia – 1
Phillipines – 1
Poland – 1
Morocco – 2
Iraq – 1
15 of the above cases involved Thoracopagus conjoined twins. Again, according to the undated material, NGHA has successfully separated 13 sets of conjoined twins. 20 sets were evaluated but not separated. 1 set was attempted to be separated
without success and the operation was aborted. The 20 cases which were not operated on were due to the following factors: sharing a single heart; major communicating hearts; major anomalies.
Due to the Kingdom’s reputation for breakthroughs and innovations in the separate of conjoined twins, physicians and researches from all around the world seek the opportunity to come to National Guard Health Affairs for the opportunity to work and study under Dr. Al Rabeeah and his surgical team.
While well known in international medical circles these ongoing acts of humanity in the separation of conjoined twins is not as widely known outside of the Kingdom as one would expect. Therefore I hope this post has helped inform and educate you as a reader of this blog of one of the Kingdom’s incredible ongoing endeavors.
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