Iranian twins die in surgery
 
 
There were unexpected delays during the first phase of the surgery 
Both the conjoined Iranian twins have died during a marathon operation to 
separate them. 

Ladan Bijani was the first to succumb, shortly after surgeons separated her 
head from that of her sister. 

Laleh died an hour and a half later, hospital officials have confirmed. 

In a statement they said: "Raffles Hospital regrets to announce that the Bijani 
twins, Ladan and Laleh, have both passed away during surgery to separate them." 

Earlier, hospital spokesman Dr Prem Kumar explained that the 29 year-old 
sisters had both lost a lot of blood during the operation and were in a 
critical state. 

A team of 28 doctors and 100 medical assistants were involved in the surgery to 
separate the twins. 

 


Look at an illustration of the operation  

As the operation progressed, it became clear the brains had fused together 
after 29 years sharing the same skull cavity, and the separation would not be 
as straightforward as anticipated. 

Surgeons spent some 21 hours cutting the twins' brains apart "literally 
millimetre by millimetre" - something that they had not expected to have to do. 

The final moment of separation came after 53 hours of the complex operation. 

The procedure was further complicated because the blood circulation between the 
twins was unstable. 

Dr Loo Choon Yong, chairman of Raffles Hospital, said that at one stage the 
specialists had stopped to consult the twins' next of kin. 

Choice 

He said there was the choice of taking the twins into intensive care and off 
anaesthetic while the next stage was planned. This would have carried a risk of 
infection or even losing the twins in intensive care. 

The alternative option was to continue with the final stages of separation 
which would also be risky. 


 If God wants us to live the rest of our lives as two separate independent 
individuals, we will 

Ladan Bijani 


Message from Bijanis 
Surgeons' sorrow  

"The team wanted to know once again what were the wishes of Ladan and Laleh," 
said Dr Loo. 

"We were told that they wanted to be separated under all circumstances." 

Half an hour after surgeons completed the separation, Ladan's circulation began 
to fail and, despite the efforts of the team, she died. 

Surgery continued on Laleh but her circulation also started to fail and she 
died 90 minutes later. 

Dr Loo said: "When we undertook this challenge we knew the risks were great and 
one of scenarios was that we might lose both of them. 

"Ladan and Laleh knew that it too." 

The twins were warned that they had only a 50-50 chance of survival, but said 
they were willing to risk death for the chance to lead separate lives. 

Iranians living in Singapore had gathered at Raffles Hospital to pray for the 
Bijani sisters during the marathon surgery. 

After the news of Ladan's death, a group of weeping Iranian women were escorted 
away by friends. 

"I was shocked. I still don't believe it. Ladan was very friendly, she always 
liked to joke," said Hossein Afkami, 42. 

Quality of life 

The operation marked the first time surgeons had tried to separate adult 
craniopagus twins - siblings born joined at the head - since the operation was 
first successfully performed in 1952. 


German doctors had turned away the Bijanis in 1996, deeming the operation to be 
too risky. 

The 29-year-old sisters were well-known in their home country for their courage 
and academic success - both graduated after studying law. 

Iranian government spokesman Abdollah Ramezanzadeh said that the nation was 
in "deep sorrow" following their deaths. 

"We were praying for them to be successfully separated, since that was their 
ultimate wish, " he told French news agency AFP. 

Iranian television went live to Singapore to bring the nation the sad news. 

The BBC's Frances Harrison, in Tehran, said many people said they would be in 
mourning because the twins were like family figures after their lives had been 
charted by the Iranian media. 

 


\\\\\\\"Always be a first rate version of yourself instead of a second rate 
version of someone else.\\\\\\\\\\\\\"

Njoki Paul 
University of Pretoria 

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