SINGAPORE: Iranian twin sisters joined at the head face hours more surgery lasting well into yesterday, a hospital spokesman said last night, although doctors expressed cautious optimism that the operation to separate them was going well.
Dr Prem Kumar Nair, a spokesman for Singapore's Raffles Hospital where the operation was under way, said the 29-year-old twins, Laleh and Ladan Bijani, had tightly fused brains, which was slowing down the operation.
"Although the brains are distinctly separate, because they have been fused for the last 29 years, they are very adherent to each other.
"Dissection to separate them is thus taking a long time," he said.
The second stage of the operation, after the craniotomy or opening up the women's combined skulls, involves severing blood vessels and veins around their brains.
The latest stage started at 5 p.m. local time (10 a.m. Irish time) and had been scheduled for completion in 10 hours.
"A large portion of the skulls has actually been separated, blood vessels will be separated only with the separation of the brain," Dr Nair said, adding that the twins' circulatory system was still connected.
He said the team of neurosurgeons had to cut carefully through the sisters' brain tissue millimetre by millimetre.
"We anticipate that the surgery will continue well into the night and tomorrow, until such time the surgeons can adequately separate the brains and ensure that the blood circulation is stable," Dr Nair said.
The operation has drawn worldwide media attention. Yesterday, Iranian President Mohammad Khatami pledged to cover the cost of the operation, which is estimated to cost about $300,000.
Scores of family and friends were anxiously awaiting the outcome of the dangerous surgery, including the twins' elderly parents in Iran and friends in Singapore. Supporters have been holding a prayer vigil at the hospital since surgery began around midday on Sunday.
The high chance of fatality for one or both sisters - historically four in five such operations have left one or both of the twins with severe complications such as brain damage or a vegetative state - has raised ethical concerns.
German doctors turned away the twins in 1996, saying splitting them could prove fatal.
But the Bijanis were determined to lead separate lives and persuaded Singapore doctors to carry out the surgery, despite the risks. - (Reuters)