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"Infants with this disease heal faster and better as soon as they are separated, because of the plasticity and regenerative powers of the young brain," said the neurosurgeon. Gregory Heuer, MD, PhD, who co-directed the operation with a plastic surgeon Jesse Taylor, MD, as members of a multidisciplinary team of 30 people. "However, we must strike a balance between this benefit and the risks badociated with major surgery in infants, particularly in an extremely rare complex condition."
For Siamese twins, who were already rare, the state of the Delaney twins was one of the rarest among the few. Siamese twins of Craniopagus occur about six times out of 10 million births and, even more rarely, the girls were totally fused, their connection extending deep into the brain tissue. In particular, they shared a superior sagittal sinus, the great vessel that carries blood from the brain to the heart.
The current report explains in detail how the team has used and adapted sophisticated surgical technologies for separation. Computer-aided design and modeling allowed the team to print a three-dimensional model to facilitate surgical planning. After the surgeons had first pierced the bones where the babies' skulls were badembled, the team attached a custom-designed external distraction device, which very gradually separated the twins from one or two millimeters a day before a complete separation several months later.
For the final separation operation, the team used a computer-badisted intraoperative navigation system to map interconnected blood vessels, particularly the sagittal sinus, which had to be carefully divided between the twins. This visualization tool provided ongoing knowledge of the surrounding anatomy during surgery, when vessels and brain tissue were sometimes partially masked.
Erin and Abby joined the hospital's intensive care unit after the eleven-hour separation surgery and were referred for inpatient rehabilitation two months later, shortly after their first birthday. Erin was released in October 2017, four months after surgery, and stayed at her parents' home at Ronald McDonald House in Philadelphia until Abby was released a month later. They finally got home North Carolina just before Thanksgiving in 2017.
The review article summarizes the status of the twins 11 months after the separation, while they were 21 months old. Surgeons and clinicians will continue to monitor girls' progress for years to come. As during their stay at the hospital, Erin and Abby will continue to be followed by nutritionists, development pediatricians and other specialists. In addition, both will need a synthetic implant at the age of four or five to cover the openings in their skull made necessary by the separation surgery.
Meanwhile, their parents report that Erin and Abby, who are now two and a half years old, "exceed all expectations." Heather Delaney "Erin crawls everywhere and enjoys her newfound freedom … she is so engaged and curious." His sister Abby begins to sit alone, energetic and impertinent. "She rolls home as if it was her job and took care of everything," Heather added.
"We are very grateful and we feel so happy that we can be their parents and watch them grow and prosper," he said. Riley Delaney.
Dr. Taylor, now head of CHOP's Division of Plastic and Reconstructive Surgery, added, "After this long and complicated operation, these little girls are recovering, growing and growing up, and we are honored to have contributed to the achievement of this objective. "
Note to the media: Organize interviews with Drs. Heuer or Taylor, or with Heather and Riley Delaney, please contact Ashley Moore 267-426-6071 or [email protected]
Gregory G. Heuer et al, "Separation of Twins Craniopagus by a multidisciplinary team" New England Journal of Medicine, January 24, 2019.
About the Children's Hospital of Philadelphia cream: Children's Hospital Philadelphia cream was founded in 1855 as the country's first pediatric hospital. With a long-standing commitment to providing exceptional patient care, training new generations of pediatric health professionals, and launching major research initiatives, the Children's Hospital has led to many discoveries including children from around the world. have benefited. Its pediatric research program is among the most important in the country. In addition, its unique family-centered care and public service programs have enabled the 546-bed hospital to become the leading advocate for children and adolescents. For more information, visit http://www.chop.edu
Contact: Ashley Moore
Children's Hospital Philadelphia cream
(267) 426-6071
[email protected]
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