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A pair of male twins from Limpopo were born conjoined and a multi-disciplinary team of health professionals at Sefako Makgatho Health Sciences University (SMU) performed a successful separation surgery. Multiple departments in the School of Medicine came together to plan and execute this complex operation. The surgery was the first of its kind at SMU since the establishment of the institution three years ago.

The pair were joined at the abdominal area and were sharing a liver. It took four months of planning before to the surgery was finally performed. This time was used for further investigations, planning, multiple drills and most importantly to offer the mother and her family the necessary psychosocial support. The surgical time was 180 minutes (3 hours) and there was minimal blood loss. The pair had to return to the theatre to complete the skin closure process. The twins have made excellent progress postoperatively and they are currently recovering at the Dr George Mukhari Academic Hospital. The expertise of the team was crucial during the surgery procedure, due to the complex technique of dividing the liver that the infants shared. Their livers will probably fully develop before the age of one again.

The multidisciplinary team consisted of Specialists from the Departments of Anaesthesiology, Paediatrics, Paediatric Surgery, Plastic Surgery, Radiology, Clinical Psychology and Social Work. There was a huge amount of support from the hospital management, supply chain management and Nursing staff from DGMAH. The separation was said to be a highly critical procedure as the twins were joined in a difficult area. “The dangers we were mostly worried about were bleeding and damaging the intestines but we were very lucky that everything went well” said Dr Nyaweleni Tshifularo, a paediatric surgeon who was part of the separation team.

Conjoined twins are identical twins that are joined and fused together in their mother’s womb. This complication is normally missed during pregnancies and is found when the babies are born. However, this condition cannot be prevented in anyway, as it happens during the process of egg fertilisation; an abnormality extremely rare but seen slightly higher in other parts of Africa and Asia.

The parents of the boys are thrilled and have been appreciative of the wonderful care that they are receiving together with their children at the DGMAH.