Conjoined twins Trishna and Krishna have spent their first night in their own beds after groundbreaking surgery at Melbourne’s Royal Children’s Hospital to separate them.
The girls, who are almost three, were joined at the head and endured more than 31 hours of surgery.
They now face a battle for survival as they recover in the hospital’s intensive care unit.
A team of Australian surgeons performed a series of complex procedures on the tiny sisters, working through Monday and into Tuesday afternoon, while the nation waited for news.
The delicate task of separating their heads was completed at 11am (AEDT) on Tuesday.
Then, cranio-facial surgeons stepped in to reconstruct the girls’ skulls using a combination of their own skin, bone grafts and artificial materials.
Risk of deadly infections
More than 31 hours after their procedure started, the sisters, aged two years and 11 months, were out of the operating theatre by about 4pm on Tuesday and taken to intensive care.
Royal Children’s Hospital chief of surgery Leo Donnan said Krishna and Trishna were recovering well.
But they face many risks, including infection, following the marathon operation.
Mr Donnan said it may not be known for “a long time” whether they sustained brain damage, so now was not the time for celebration.
“Doing operations like this… you are guarded. Everyone will be very pensive at the moment,” he said.
“It was a relief, but everyone realised there is still a long way to go and that the girls have a very difficult time ahead of them.”
The twins were given a 25 per cent chance of coming through the operation unharmed, with a 50 per cent chance they would be brain damaged and a 25 per cent chance one of them would die.
‘Every step an improvement’
“There is no one moment of great celebration. There’s relief and it’s nice to know that we’re onto the next stage,” Mr Donnan told reporters.
“We’ve got a lot of unanswered, unknown territory we are moving into but all I can say is that everything is in place for the best possible outcome.
“Every step is an improvement.”
Krishna and Trishna were born in Bangladesh, and were handed over to an orphanage in Dhaka, where their health declined.
They were brought to Australia in November 2007, and were nursed back to health, developing a unique system of crawling on their backs – and a love of Australian children’s band “The Wiggles”.
Separating conjoined twins is a notoriously difficult procedure, with attempts in Britain and Bangladesh both failing over the past year, although Saudi doctors successfully divided a pair of Egyptian brothers in February.
In one of the best known cases, Singapore doctors in 2003 made a vain attempt to separate adult twins — Iranian law graduates Laleh and Ladan Bijani, 29 — who died from severe blood loss after 52 hours of surgery.