“We knew that if we didn’t separate them, both would not survive,” said Dr. Gordon Thomas, a pediatric transplant surgeon.
After a rare set of conjoined twins reached a “critical level” due to the smaller twin’s congenital heart condition and underdeveloped lungs placing both of their lives at risk, doctors and surgeons spent eight hours carefully separating the pair in the operating room.
Tom and Sawong, who were born on Oct. 9 in a remote part of Papua New Guinea (PNG), were joined at the lower abdomen at birth, sharing a single liver and parts of their gastrointestinal tract, according to the Australian Broadcasting Corporation (ABC). Following weeks of tense discussions, their doctors and families arranged for them to undergo highly complex surgery at a children’s hospital in Australia.
“There’s nothing in the textbooks about a situation like this,” Dr. Gordon Thomas, a pediatric transplant surgeon at The Children’s Hospital at Westmead, told ABC of the rare case. “Every case of conjoined twins is unique in its own way.”
“We had lots of unusual clinical findings in the twins that we had to understand,” he continued, highlighting that his team spent days determining whether or not the twins could be safely separated. “For instance, Tom’s upper part of the body appeared blue, but the rest of his body was pink. How do you explain that?”
Tom and Sawong shared a liver, part of their gastrointestinal tracts and major blood vessels, which Dr. Thomas said presented “complex and difficult challenges to solve.” Tom’s congenital heart condition and small lungs also relied heavily on his brother to stay alive.
“We could see Sawong breathing very fast,” Dr. Thomas explained to ABC. “We could see him constantly hungry. We could see his heart beating very fast because he was effectively supporting both of them.”
After hours of examinations, medical professionals came to the conclusion that Tom’s condition was “not compatible with long-term survival,” and that the only way to save either of the twins was to focus on Sawong, who had the best chance of surviving.
“We saw a little baby who had a very good chance of survival, provided we could carry out a safe separation,” Dr. Thomas said of the infant. “We knew that if we didn’t separate them, both would not survive.”
In order to give Tom the best possible chance, a team of doctors worked to carefully transfer the twins from Papua New Guinea to Sydney, Australia, ABC reported.
According to Tracey Lutz, a retrieval specialist and neonatologist, the journey was not an easy one.
“It was always going to be a challenging mission because of the distance,” she told the outlet. “It took us over five hours outside of the hospital setting.”
