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Twins Undergo Dramatic 18-Hour Operation

June 14, 1994

JOHANNESBURG, South Africa (AP) _ Doctors and a medical team of 50 people began an estimated 18-hour operation today to separate Siamese twin girls connected at the back of the head.

Nine-month-old Mahlatse and Nthabiseng Makwaeba are the first Siamese twins in South Africa who will benefit from a new surgical technique using brain- covering tissue taken from a cadaver. The tissue protects their brains from blood loss and infection after the operation.

″The twins were healthy yesterday and we don’t expect any complications,″ said Simon Nemavhulani, a public relations officer at Garanukuwa Hospital.

The operation, headed by U.S. neurosurgeon Dr. Benjamin Carson of Johns Hopkins Hospital in Baltimore, began at 7 a.m. at the Garankuwa Hospital outside Pretoria.

Carson, who separated Benjamin and Patrick Binder in West Germany in 1987, will be assisted by 25 doctors including plastic surgeons, neurosurgeons, cardiac surgeons, radiologists and anesthesiologists, and an equal number of nurses and other professionals.

The team was to prepare the twins for the surgery, then begin the delicate separation of their converging veins.

The operation’s most delicate phase is one hour in which the twins must be separated, severed veins reconstructed and blood flow re-established. ″Any longer would increase the risk of brain and other organ damage,″ said Carson, quoted in The Star of Johannesburg.

The operation also involves lowering the twins’ temperature so that their hearts stop beating while they are connected to a cardiopulmonary bypass machine.

A similar operation was performed successfully in South Africa in 1988.

In the weeks before the surgery, the twins underwent a procedure in which a silicone bag was implanted under the scalp of each girl. Liquid has since been injected into the bags so that enough skin will cover the backs of their reconstructed heads.

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