A closer look at the successful severance of conjoined twins

At 6 a.m. Wednesday, HCMC Children's Hospital staff lead two 13-month-old conjoined twins, Truc Nhi and Dieu Nhi, to surgery, gathering around 93 doctors, nurses and medical experts from several HCMC hospitals.

The siblings were classified Ischiopagus Tetrapus (Quadripus) conjoined twins, which means they have a symmetrical continuous longitudinal axis with their area of union not broken anteriorly. If a pair of conjoined twins is born for every 200,000 births, only 6 percent of such cases are classified as Ischiopagus Tetrapus, doctors said. The twins have a colon frame and only one anus, two bladders located on both sides of the abdominal cavity, and a circular pelvis.

To distinguish the two children and to avoid confusing personnel and surgical equipment, nurses stuck color paper to each of their foreheads.

Two nurses soothe the tiny patients pre-anesthesia.

Since the twins had yet to be separated and still experienced conjoined drug exchange, the anesthetic team had to be very careful when administering dosages, taking nearly three hours to complete the procedure.

Truong Quang Dinh, director of HCMC Children's Hospital (wearing stethoscope) and the operation leader, check the heart rate and blood pressure of Dieu Nhi. At 7:30 a.m., the surgical team make the final checks before commencing the operation.

During the period of anesthesia, Dieu Nhi appeared inherently weaker than Truc Nhi. Luckily, the children remained relatively stable throughout the surgery.

Doctors wear surgical magnifying glasses, ensuring accuracy and safety.

The first surgical cut is done at 9:51 a.m.

Tran Van Duong, a doctor from the Department of Orthopedics and Trauma-Surgery of Cho Ray Hospital, heading the plastic surgery team, cuts open the belly to separate the two babies, with the General Surgery team carefully determining the separation of intestines.

Surgeons carefully observe the patient's abdominal cavity via an ultrasound screen.

At 2:07 p.m., doctors and nurses celebrate the successful decoupling of the two girls.

Truc Nhi is transferred to a separate operating room to continue plastic surgery while her sister Dieu Nhi receives treatment in situ. When splitting the twins, doctors decided to assign the common ileum, ileocecal valve and half of the right colon to Truc Nhi and create artificial parts for Dieu Nhi.

The parents (first and second left) are happy to embrace their baby girls once surgery concluded at 6:45 p.m. "The journey to full recovery is still long," Dinh confirmed.

Tran Dong A, the 79-year-old doctor having separated many twins in Vietnam, said: "The success of today's surgery marks a new milestone in their lives, and signals that Vietnam's health sector is thriving."

The twins regained consciousness on Thursday morning. They continue to undergo ventilation support and pain relieve medication. A hospital representative said that the babies only had mild fever due to inflammation post surgery, a normal body reaction, and are in stable conditions.