Hungarian surgeons separate Bangladeshi twins joined at head

Bangladeshi twins who were joined at the head were recovering Friday after Hungarian surgeons performed a marathon 30-hour operation to separate their skulls and brains in the capital Dhaka.

The twins, named Rabeya and Rukaya, turned three last month and suffered from a rare embryological disorder affecting an estimated one in every five to six million births.

They were "stable after the final separation," said Andras Csokay, a neurosurgeon with the Action for Defenceless People Foundation (ADPF) medical aid charity that performed the operation.

"But we have to be very careful during the postoperative period," Csokay, who headed the 35-strong Hungarian team, told AFP.

After the separation of their skulls and brains at Dhaka's Combined Military Hospital, Csokay's team began to cover the wound area with soft tissues generated by a tissue expansion process carried out in Hungary.

Prior to the surgery doctors had said there was only a 50 percent chance of both of the twins surviving.

According to ADPF, only a handful of operations to separate twins joined at the head have ever been successful.

The Hungarian charity was set up in 2002 by Csokay and plastic surgeon Gergely Pataki to provide free surgery to poor people in Hungary and abroad.

The parents of the twins, who are from Pabna, 120 kilometres (75 miles) west of Dhaka, approached the group for help in 2017.

In the first surgery phase in Bangladesh last year, the shared blood vessels of the twins' brains were separated in a 14-hour operation.

Then in a second six-month-long phase beginning last January, Rabeya and Rukaya moved to Budapest where doctors inserted a Hungarian-designed implant system to expand the scalp and soft tissue in their heads.

During the period over 40 plastic surgery interventions took place to fill the expanders, change the bandages and to perform laser and regenerative wound treatment.

ADPF neurosurgeons and plastic surgeons supported by anaesthesiologists, radiologists and pediatricians also used innovative virtual 3D animation software to map the two brains.

"This was one of the biggest most challenging malformations that I have ever seen," Pataki told AFP in Budapest last month.

The twins and Hungarian medics then returned to Bangladesh late July ahead of the final separation phase.

ADPF has performed around 500 reconstructive surgery operations in Asia and Africa, including for Rohingya Muslim refugees in Bangladesh.