Grant McArthur and Peter Familari with AAP
source: herald sun
November 18, 2009 10:25AM
Comment: so does that mean the more I roast, the sooner I could become a brain surgeon?
SEPARATED conjoined twins Trishna and Krishna appear to have suffered no brain damage as they remain in a serious but stable condition in Melbourne.
A team of Australian surgeons performed groundbreaking surgery on the sisters yesterday, who were joined at the head, at the Royal Children's Hospital.
A hospital spokeswoman said the girls' condition had not changed overnight and they remain in a serious but stable condition and connected to ventilators.
Chief surgeon Leo Donnan said there was currently no evidence the girls suffered any brain damage.
He said despite the success of yesterday's surgery, the chance of the sisters coming out of the procedure unscathed was still just 25 per cent.
"That was always a long-term prognosis and a long-term view, not just from the surgery that was performed yesterday," he said.
"We have still got many unknown things that will need to be addressed related to how well they recover from the surgery and how their bodies adapt to the separation."
But he said apart from the risk of infection, the girls' bodies needed to adjust to operating independently.
"They both will have issues with their kidneys and with other organs as well," he said.
"There is a whole lot of changes that will occur over the next couple of weeks, even into months, and we really don't know how well they will tolerate those."
The twins were given a 25 per cent chance of coming through the operation unharmed, with a 50 per cent chance they would be brain damaged and a 25 per cent chance one of them would die.
Details of the marathon surgery have emerged, with medical specialists revealing how they fought fatigue throughout the 32-hour surgery.
Associate Professor Donnan said there were plenty of tricks used by the 16-member medical team to battle fatigue, including the use of "light pop" music, the Herald Sun reports.
Taking regular breaks and being fit and rested before the surgery were essential, Mr Donnan said.
"They make sure they have some time where they don't think about what they're doing, so they'll step away and they will listen to some music during the time - of course they will," he said.
"In long cases like this there are waves when you feel a bit tired and then other times when concentration is very important, everything just disappears, and you concentrate on the job at hand."
Anaesthetist Dr Ian McKenzie said coffee was a mixed blessing.
"People can live on it but if you keep flogging coffee you sometimes feel worse later on," Dr McKenzie said.
"There are people who do micro-surgery who avoid caffeine so they don't have twitchy fingers during delicate surgery," he said.
"We had some music from about 3 o'clock in the morning through to about six o'clock. It's the type of music I'm willing to listen to but it's not my favourite music. It's a sort of light pop."
Fatigue had been a concern for the surgeons, but they had all managed to have some sort of sleep, he said.
The biggest burden had fallen on neurosurgeon Wirginia Maixner and her team, who spent many, many hours on their feet delicately separating the girls' brains.
However, because the surgery had been planned so meticulously and far in advance, there had been some changes of shifts.
"We've had plenty of time to sort the diaries of anaesthetists, surgeons, anaesthesia technicians, nurses, all sorts of staff," Dr McKenzie said.
Plucked from a Bangladesh orphanage two years ago, the conjoined twins survived the marathon of surgery that doctors say will give them every chance of healthy - and separate - lives.
Emotional guardian Moira Kelly last night told friends "the girls look absolutely beautiful".
The beds have been positioned as close as possible to reduce any shock the orphans may feel when they wake and find themselves apart for the first time since they were born almost three years ago.
The twins were separated at 11am in a moment that brought tears and elation to the 16-strong surgical team.
Dr Donnan emerged with a huge smile just after 4pm to tell the world the operation had delivered the best result possible.
The separation came two years and two months after aid workers in Bangladesh turned to Ms Kelly's Children First charity as a last-ditch effort to save the twins.
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