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Wednesday, 12 December, 2001, 12:29 GMT
Pioneering Siamese twin op
one twin and x-ray
The twins, joined at the spine, have now been separated
Surgeons in Birmingham have successfully separated twin girls born joined at the base of the spine, in only the third ever operation of its type.

Eman and Sanchia Mowatt were born at the city's children's hospital three months ago.

They shared a single section of bowel, and, more importantly, a length of spinal cord.

Nobody in this country has any experience in doing this back to back operation.

Mr Tony Hockley, Birmingham Children's Hospital
However, a team of surgeons carried out a marathon 15 hour operation on the twins, and believe they have separated the cord without any adverse effects.

Doctors are hopeful that they will be allowed to go home for Christmas.

David and Emma Mowatt, the twin's parents, said they felt "overwhelmed" by the success of the operation, and said they were looking forward to taking them home.

Conjoined twins, often nicknamed "Siamese" twins, are extremely rare - there has only been one other case in the last 30 years in Birmingham.

Back connection rare

In addition, most other cases involve twins joined facing each other, rather than back to back.

Now that they have been separated they miss each other. They cannot feel each other

Emma Mowatt
While conjoined twin surgery has advanced significantly in the past decade, success in such operations depends primarily on whether vital organs such as the heart or brain are shared.

In this case, the twins were not in any immediate danger, and could be taken home between the birth and the operation, although extensive scans were taken so that surgeons could prepare for their task.

Mr Tony Hockley, the neurosurgeon who performed the pioneering spinal separation, said: "The spinal cords met in a Y-shape, and we separated them so that each baby then had her own spinal cord."

There was no obvious line between Eman's portion of the shared cord, and Sanchia's - so one had to be created, with surgeons hoping that this would not leave one baby with less ability to move than before.

No obvious problem

However, although each has one leg weaker than the other, their condition at the moment appears to be unchanged from prior to the operation.

Mowatt family
The family have coped will with the experience
Mr Hockley said: "Nobody in this country has any experience in doing this back to back operation.

"We have now got enough function in either spinal cord to keep these legs working."

Emma Mowatt said that each girl, despite being joined, had a distinct personality, and that her greatest joy was now being able to pick them up separately.

She added: ""The way that they were, they used to bury their heads behind each other.

"Now that they have been separated they miss each other. They cannot feel each other."

Although the operation was principally carried out by surgeons from hospitals in the Birmingham area, they had assistance from conjoined twins expert Lewis Spitz, from Great Ormond Street Children's Hospital in London.

Skin stretching

Apart from the spinal separation, surgeons had to overcome both the joined bowel, and a severe shortage of skin with which to close the large wound created by the operation.

To solve the latter problem, in the weeks leading up to the operation, a balloon was inserted under the twin's skin and gradually filled to stretch it out, so it could cover more surface area.

The BBC's Karen Allen
"Twins born back-to-back are extremely rare"
The BBC's Chris Hogg
"The separation had never been tried before in this country"
See also:

17 Jun 01 | Health
Siamese twin returns home
25 Aug 00 | Q-S
Siamese twins
06 Apr 01 | Asia-Pacific
Surgery to separate Siamese twins
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