Surgical Separation of Pygopagus twins at Apollo Children’s Hospital, Vanagaram

TWINS...  A NATURE'S BLESSING TO HUMANITY. BUT TO BE JOINED FOREVER... ?

Let me introduce to you Ericana and Eludi are conjoined twins, who were brought to Apollo Children’s Hospital, Vanagaram by their mother to seek help. This is a true story of a mother, struggling to give her children the life they deserve. All she want from you is love and Prayers. 

Meet Ericana and Eludi, whom the nurses in the hospital lovingly call Ammakutty and Chellakutty.

Such innocents. They are meant to be happy in life and they will. Lets all join together today, forgetting our class, religion barrier and pray from these lovely blessings. GOD YOU HAVE TO LISTEN.

This is the story of two identical ‘pygopagus twins’ from Africa.

What is Pygopagus?

image courtsy: www.gfmer.ch

The term pygopagus means – ‘fixed at the buttocks’.

The mother hails from a small village called ‘Kasumulu’ in Tanzania. She went for delivery to the dispensary in her village from where she was shifted to the District Hospital because she had undergone a previous cesarean section.  At the district hospital a  ‘C ‘section was done but to the doctors' surprise there was enormous difficulty in delivering the babies out of the uterus as they were joined at the back. The mother was told that separation of the babies was fraught with risk and she was sent to the Mohimbili Hospital in the capital Dar es Salaam by ambulance. It took three days to make this journey with the newborns. At Mohimbili the doctors contacted the health officials for advise regarding further action.

Apollo Hospitals Chennai is closely associated with the Tanzanian

government by the Save a Childs Heart Initiative (SACHI). The babies were therefore shifted to Apollo Children’s Hospital in Chennai at four and a half months of age. After extensive work up it was found that the babies were joined at the tail end of the spines and shared a single anus and rectum. They were also found to have a single phallus and urinary passage.

The Operation Details

Separation of these babies is a mammoth task, which will take around 14 – 16 hours.It is being planned on the 16th of December. A team of 20 doctors from the specialties of neurosurgery, plastic surgery, paediatric surgery and pediatric urology will attempt the separation. The services of Dr.Edward Kiely – Paediatric Surgeon and Dr.Richard Howard – Anaesthesiologist both from Great Ormond Street Hospital in London have been sought to guide and help in the safe separation

Conjoined twins are rarely encountered. Although seen in one in 200,000 deliveries more than 60% are stillborn. Of the remaining, 35% die within a few days or months of birth due to various causes.

Conjoined twins can be joined at the chest, abdomen, back, buttock and head. Fusion at the buttocks (Pygopagus) is very rare and accounts for less than 17% of all conjoined twins.

Live born pygopagus twins are usually female in sex. Male pygopagus twins are  very rare. Till now in medical literature only 30 sets of pygopagus twins have been reported. Of these 26 were female and only four were male.

This set of male pygopagus twins for which separation is being done at Apollo Hospitals Chennai is the first in India. A unique and challenging aspect of the separation is the fused phallus, which has to be delicately separated to give each baby a functional penis.

The babies are now 9 months old and weigh 16 kgs. During the last five months tissue expanders have been placed in the back, buttocks and thighs so that skin flaps can be rotated to cover the large defects, which will be left after separation.

 The nurses looking after the babies have been showering love and affection on the babies who have been nicknamed ‘Ammukutty’ and ‘Chellakutty’.

The babies can say ‘Thatha’ and ‘Athai’ and the mother has picked up a smattering of Tamil as well.

We are very confident that the separation of these babies will proceed uneventfully.

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