Post uncoupling at AIIMS, Jagga & Balia return home

Tribune News Service

New Delhi, September 6

Specialists at AIIMS here made history today by successfully separating twins  — Jagga and Balia — fused at the head, a rare condition that is present in one out of 25 lakh births and poses 80 per cent risk to the lives of children involved.

“This is the first successful craniopagus conjoined twin separation surgery from India wherein both children have survived…Worldwide only 10 to 15 children have survived after such surgical separation in the past 50 years. This is an extremely rare condition,” Health Minister Harsh Vardhan said today applauding the AIIMS team for their feat. Vardhan said Indian scientists and doctors have both done the country proud today.

The minister’s reference was to India’s moon landing led by ISRO.

The twins, born in Odisha’s Kandhamal, infamous for its highest infant child mortality rate in India, were brought to AIIMS in 2017 and the process of detailed surgical planning was underway since then.

The AIIMS experts employed all modern adjuncts of technology for the surgical planning, including 3D print model technology for brain and skull model development, venous bypass, staged surgeries and continuous postoperative care. A team of 75 doctors and 50 nursing and support staff worked on the case.

A similar surgery in the US had cost USD 2.5 million (Rs 17 crore) in 2016, but was done free of cost for the children from the tribal belt of Odisha.

Deepak Gupta, professor of neurosurgery at AIIMS, today outlined various stages in the journey of the case since the twins were admitted to the neurosurgery department on July 14, 2017.

“Detailed planning for surgical separation was carried out on these conjoined twins totally fused to each other at head level (Craniopagus twins) by 125 doctors and our support team. The first stage surgery, lasting 25 hours, involved creating a venous bypass on Balia and partial brain separation from Jagga, and was conducted on August 28, 2017. The final separation of the two children was successfully done on October 25, 2017, in an operation which lasted 20 hours,” Gupta said.

Skin grafting and minor neurosurgical procedures followed to cover skin defects on the twins by the plastic surgery team over next few months. The twins have now been put on the train to home with an AIIMS team accompanying them.

Dr Gupta said the Jagga-Balia case was highly complex as the twins shared venous return (circular sinus) and were totally fused at the head.

After their birth in Kandhamal, the twins were kept at a local medical college in Cuttack. They were eventually brought to AIIMS for a surgery after the parents were briefed on possible life risks.

Rare condition 

This is the first successful craniopagus conjoined twin separation surgery from India wherein both children have survived, says the Health Minister

While Jagga is developing well in all domains and can join special school in Odisha immediately after returning home, Balia is likely to remain neurologically disabled