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Singapore Doctor Still Considering Indian Twins’ Operation
Monday April 20th, 2009 / 11h22
SINGAPORE (AFP)—A prominent Singapore
doctor said Monday it was “premature” to rule out an operation to
separate Indian twin sisters joined at the head despite a warning
from his own country’s health minister.
Neurosurgeon Keith Goh, who had been asked by the state
government of Andhra Pradesh in India to separate five-year-old
twins Vani and Veena, said he was still in discussions with doctors
and officials in Hyderabad on the case.
Goh said he would not be able to confirm any surgery until more
thorough investigations had been carried out.
But he disagreed with published remarks by Singapore’s Health
Minister Khaw Boon Wan cautioning that an operation is more likely
to harm the patients than improve their situation.
“I think that Mr. Khaw is entitled to his opinion…but that it is
a little too premature to close our minds to the possibility of
doing such an operation, especially when the full evaluation and
all the investigations have not been done,” Goh told AFP.
He also disagreed that separating conjoined twins amounted to
changing the course of nature.
“Nature never intended for any of us, humans or animals, to be
conjoined to another individual,” said Goh.
The Indian twins “represent a most extreme form of congenital
malformation and deformity, and should be considered an aberration
of what nature intended,” he said.
“If such patients ask for help to correct their abnormalities, I
feel that we, as doctors, owe it to them to see what we can
do.”
Health Minister Khaw said in remarks carried Monday by the
Straits Times that in certain situations, it may be better not to
operate on conjoined twins.
He also said that in some cases, surgeons have to pick one twin
to die in order to save the other, and the survivor is often left
with brain damage.
In 2001, Goh was involved in a 97-hour operation that separated
11-month-old Nepalese twins Ganga and Jamuna Shrestha, who were
born with fused skulls.
The surgery left Ganga with brain damage and Jamuna unable to
walk. It also left a hole in Jamuna’s skull covered only by a layer
of skin.
Ganga survived for seven years before dying last year from
respiratory problems at a hospital in Kathmandu.
Goh was also involved in the tragic operation of 29-year-old
Iranian twins – Ladan and Laleh Bijani – in July 2003. Both women,
joined at the head, died from severe blood loss following a 52-hour
operation.
“Let me point out that Ganga and Jamuna both survived the
separation surgery, and that Ganga’s survival after the surgery was
seven years, dying only because of a chest infection,” Goh
said.
“Jamuna is still surviving and is a happy, intelligent and
delightful child, although she has some limb weakness.”
Goh said his preliminary assessment of Vani and Veena showed
their clinical condition is very similar to that of the Nepalese
twins.
He believes a “better outcome” can be achieved with the Indian
pair because “the collective experiences and knowledge of all the
centers worldwide which have done such conjoined twins surgeries is
much more than in 2001.”
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