Egyptian twins joined at head successfully separated in Dallas

Monday, October 13, 2003

DALLAS -- Two-year-old Egyptian twins joined at the top of their heads were separated Sunday in a 34-hour operation that took more than a year of planning.

Doctors at Children's Medical Center Dallas worked through the morning separating the intricate connection of blood vessels running between the brains of Ahmed and Mohamed Ibrahim -- considered the riskiest part of the operation.

They were finally separated at 11:17 a.m., hospital officials said in a prepared statement.

"They are now within striking distance of living independent lives," said Dr. Jim Thomas, chief of critical care at the hospital.

Following the separation, craniofacial surgeons began reconstructing their skulls and closing the wounds with skin and tissue created by expanders that were put in the boys' heads and thighs about five months ago.

Doctors have spent more than a year planning the surgery, which was expected to take a team of 50 to 60 medical personnel as long as 90 hours to finish.

The boys will next go to an intensive care unit, where they will remain in a drug-induced coma for three to five days, doctors said.

So far, they were doing well, Thomas said.

"We planned meticulously for this and things are going according to plan," Thomas said.

The boys were born June 2, 2001, by Caesarean section to Sabah Abu el-Wafa and her husband, Ibrahim Mohammed Ibrahim.

Dallas-based World Craniofacial Foundation, a nonprofit group that helps children with deformities of the head and face, arranged to bring the boys to Dallas in June 2002 for an evaluation.

A team of specialists determined the boys could be separated, though the risks include possible brain damage and death. The boys' father told doctors he felt it was worth it to give them a chance at a normal life.

The father spent much of the past year in Dallas with the boys before returning to Egypt this summer. He returned this week with his wife and the twins' young brother, Mahmoud.

Thomas said the parents were "doing fine."

"They have said repeatedly to all the parties involved that this is in God's hands."

The fate of the twins has become a talking point in Egypt and the Middle East, where TV news stations have been following the progress of surgery.

In the boys' hometown of el-Homr, some 400 miles south of Cairo, villagers have been praying in town mosques for the twins "to return safely," said Mohammed Ibrahim, 65, the twins' grandfather.

"If this is true then this is very good news," Nasser Mohammed Ibrahim, the twins' uncle, told The Associated Press, after learning about the separation.

But the uncle said he was anxious to have the news, relayed by TV stations in the Middle East, confirmed by his brother and the boys' father, Ibrahim Mohammed Ibrahim.

"I'm sure that everyone loves Ahmed and Mohammed, but I can only trust my brother to tell me the news," he said.

The boys' grandfather said he saw the boys only once before they left el-Homr for the United States and once again on television.

"I'm not afraid about the boys, because they are in God's care," said Mohammed Ibrahim. "We are people who believe in God, and accept destiny, whether sweet or bitter."

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