An unprecedented operation to separate adult twins joined at the head enters a critical phase today when doctors in Singapore attempt to split a major blood vessel that serves the sisters' brains.
Dozens of doctors and scores of support staff are helping in the operation to separate Iranian twin sisters Laleh and Ladan Bijani (29) in surgery expected to last at least two days, possibly three.
Surgery began today around noon when doctors harvested a vein from Ladan's right thigh.
The law-graduate twins who are willing to risk death to lead separate lives share a major blood vessel between their two brains. Surgeons need the leg vein to fashion a new blood vessel for one of the sisters before their skulls can be separated.
That part of the operation is expected to begin around midnight and last for 12 hours.
"It is probably one of the most critical aspects of the surgery. As we have said before, the key component in Laleh and Ladan's surgery is the shared blood vessel," said Dr Prem Kumar Nair, a spokesman for Raffles Hospital. Asked to evaluate the operation, he said the schedule was off by a couple of hours but everything was going as planned.
"We haven't really met any problems so far, but I would anticipate that the next 12 to 24 hours will be a very critical period and that may be where we will have to traverse some possible difficulties," he told reporters and anxious Iranian friends gathered near the hospital's entrance.
Singapore doctors performed a similar operation in 2001 on infant girls from Nepal, but experts say an operation on adult twins is unprecedented.
The sisters laughed and joked with friends as they were wheeled into an operating theatre early today, ending years of convincing doctors of their wish to lead separate lives. German doctors had turned away the Bijanis in 1996, deeming that splitting them could prove fatal.
The twins have not been deterred by the risks - Ladan wants to be a lawyer in her home town of Shiraz, while Laleh wants to be a journalist in Tehran.