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New Delhi : “It is such a great coincidence that Jagga and Balia will reach home on  September 7, 2019, and Chandrayaan II will also touch the moon the same day. It’s not only India’s scientists that are doing India proud, the commendable determination and commitment of the doctors is also  making India proud. This rarest of the rare surgery is one such shining example. It can be called “AIIMS Delhi Jagga and Balia craniopagus surgery,” stated by Union Health & Family Welfare Minister Dr  Harsh Vardhan as he interacted with the media here on September 6, 2019., on the day when the two twin brothers prepare to leave for their home in Odisha after a successful surgery to separate them at AIIMS, New Delhi.

Dr. (Prof.) Randeep Guleria, Director, AIIMS, New Delhi; Dr. (Prof.) S.S. Kale, HoD, Department of Neurosurgery; Dr. (Prof.) Deepak Gupta, Professor of Neurosurgery, and head of the team; Dr (Prof) Sheffali Gulati, Department of Paediatrics-Neurology along with other experts who were part of the team of 125 doctors and support team, were also present.

Applauding this rare feat, Dr Vardhan stated that the doctors of AIIMS have demonstrated extraordinary talent, expertise, determination and compassion in achieving it. This is the result of meticulous planning and precision of thinking. “This is the first successful craniopagus conjoined twin separation surgery from India wherein both the children have survived,” he said. He further added that worldwide only 10-15 children have survived after surgical separation of this condition in the last 50 years.

This is an extremely rare condition seen in 1 in 25 lakh live births and any kind of surgical intervention in this condition is associated with 75-80% risk of life to one or both children. “All modern adjuncts of technology for surgical planning, 3D print model technology for brain and skull model development, venous bypass, staged surgeries and continuous postoperative care was provided by the craniopagus team of over 75 doctors and 50 nursing /support team staff at AIIMS, Dr Harsh Vardhan said.

The Health Minister stated that it is a subject matter of scientific research to examine that two children from the tribal belt of Odisha were able to withstand such complicated surgery. He added that such a rare case, and the fact that the twins survived the extensive complicated surgery presents an equally rare opportunity to study the various medical and other facets of this unique case and derive valuable learnings for further medical reference and knowledge, according to a PIB release.

The first stage surgery, lasting 25 hours, involved creating a venous bypass on Balia and partial brain separation from Jagga, and was conducted on August 28, 2017. The final separation of the two children was successfully done on  October 25, 2017, in an operation which lasted for 20 hrs. Skin grafting and minor neurosurgical procedures were done on the twins to cover skin defects by the plastic surgery team over next few months.

The AIIMS doctors briefed that the Jagga-Balia case was highly complex as they shared venous return (circular sinus) and were totally fused to each other at the head level (Total Vertical type 3 with fused brains in parietal and occipital lobes).

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