Saturday, 2 December 2006
Separation Of The Conjoined Iraqi Twins
All Times are Saudi Local time (GMT +3)
Phase 1: Anesthesia
07:30 The twin have been in the room
07:45 Fatima had her anesthesia then AL Zahra was anesthetized too with no complications
08:00 The team is inserting the arterial line and the central venous lines
09:00 Phase 1 completed successfully (breathing tubes have been inserted- central venous lines- arterial line)
09:15 Endoscopy for the genital and urinary systems have completed successfully, which shows one urethra, one genital system with large urinary bladder
09:20 The surgical team now is drawing the site of the skin incision in the frontal side of the twin
Phase 2: Preparing & Planning for Skin Incision + Cystoscopy
09:30 This phase started few minutes ago by planning the incisions site then the preparation and positioning
Phase 3: Separation of the Chest, Liver & Bowel
10:00 Skin incision was made, followed by underling tissue, the incision was carried between 2 vaginae, and then the peritonium was opened
10:30 The Surgical Team opened the abdomen and identify the shared liver and shared the distal ileum and colon. It was noticed that there are (2) separated biliary system
10:50 The Surgical Team started separating the liver
12:30 The liver has been successfully separated as well as the intestine. The front part of the pelves (symphesis pubis) has been separated as well
Phase 4: Urology Separation
13:00 The urinary bladder separated successfully
Phase 5: Genital Separation  
14:00 The urinary and the genital systems have been separated without any complications
Phase 6: Joined Lower Extremity Separation
15:00 The twin flipped to separate the shared abdominal wall and the shared pelvic wall with separated of the rudimentary lower limb
18:30 The rudimentary lower limb has been successfully separated and the Team starting to separate the abdominal wall from the back side to expose and start pelvic separation
Phase 7: Pelvis Separation
19:00 The orthopedic surgeons have been separated the pelvic from the back with no complications then the rest of pelvic muscles separated as well
Phase 8: Twin Separation
20:15 The twins has been successfully separated & moved to separate beds for the first time. The Team will be divide to 2 teams A-B
Phase 9: Organs Reconstruction
22:00 Wounds for Fatima and AL Zahra are being closed
Phase 10: Dressing & Transferring Twin to PICU
23:00 The " Dressing Phase " has been completed successfully
01:00 The separation surgery for the Iraqi Conjoined Twins “Fatima and AL Zahra” has been completed successfully. The two girls have been transported to the PICU