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Based on the directive of The Custodian of the Two Holy Mosques, HRH King Abdullah bin Abdulaziz Al Saud it has been decided to proceed with the separation of the Saudi Conjoined twins, Abdullah and Abdulrahman on 2 July 2007, with the rehearsal procedure to take place on 30 June 2007, as stated by Dr. Abdullah Al Rabeeah, Head of the Multidisciplinary Surgical Team. The operation is expected to last for 21 hours and take 10 phases.

The mother of the twins was transferred from Al Madinah Al Monawarah to King Abdulaziz Medical City – Riyadh at the end of her pregnancy in order to investigate her and plan a careful delivery. She was delivered by caesarian section on 13 December 2005 and the twins were born with a combined weight of 3.39 kgs. and they were found to be joined at the lower chest, abdomen, pelvis and each of them with one normal lower extremity with a shared abnormal lower extremity between the twins.

They had many abnormalities such as an imperforate anus (unformed), extrophy of the cloaca (a urinary bladder and colon outside the abdomen with a defect in the abdominal wall) with a communication between the bowel and urinary bladder.

A Multidisciplinary team was formed and many investigations were done which showed that the twins share a liver, large bowel, urinary and genital system and one pelvis. The twins were in a critical condition and they were kept in a Neonatal Intensive Care Unit for many months. They were subjected to emergency operations, the first within two days after birth when a colostomy was created. Two months later partial repair of the urinary bladder was done which was revised on 2 occasions later.

Because of the critical condition of the twins the medical team felt that separation was risky and was delayed to ensure their stability and well-being. After several months with many meetings of the Medical team the twins started to improve and gain weight with them reaching a combined weight of 13 kgs. Hence the team decided to proceed with the separation of the twins with a success rate of 65%. On 5 June 2007, the plastic surgeons did a procedure (delay flap) for the abnormal leg in order to prepare the leg for covering the defect after separation.

This operation marks No. 14 of successful separations conducted at the King Abdulaziz Medical City, Riyadh, which has become an international center in this specialty.

31 June 2007
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