![]() Nine months prior to surgery on the Ibrahim twins, KCI went back to the drawing board. Therefore, the tables had to be parallel and concentric, and had to turn in perfect alignment to avoid putting pressure on the halos. The halos were to be mounted to the table and attached to the children by screws inserted into their skulls. One additional requirement that came to light was that the surgeons needed to put the children into cranial halos to keep their heads fixed during and after surgery. However, a rigid beam joined the two halves, and the surfaces could not rotate away from each other to give doctors easy access to the separated twins to complete the surgery. The KCI team started by modifying an existing adult bed by cutting it in half to create a table with two rigid surfaces cantilevered from each end, and open in the middle. ![]() ![]() Now they had to devise a rotating pediatric operating table in time for surgery on Ahmed and Mohamed Ibrahim. KCI has manufactured rotating beds for adults and children since 1977. ![]() The surgeons also wanted a table that could be separated after surgery so teams could complete the operation on each child independently, and in separate operating rooms if necessary. With conventional tables, surgeons do as much work as possible from above, then literally move under the table to complete the separation from below. For example, they wanted a table that could support the twins at the proper angle and rotate 360° to allow access to the entire skull area from above. Initially, the surgical team was able to describe their needs in only the broadest of terms. of San Antonio, TX in 2002 about designing an operating table to meet the critical needs of craniopagus twins.ĭesigner John Vrzalik (right) and Registered Nurse Jose Sablan (left) from KCI USA prepare for surgery on Ahmed and Mohamed Ibrahim. Recognizing the shortcomings of conventional operating tables for conjoined twins, surgeons at the World Craniofacial Foundation in Dallas consulted with hospital bed manufacturer KCI USA Inc. Holding the patients in the proper orientation was also difficult because the angle of conjunction can vary widely the tables can restrict access to certain parts of the patients' bodies. Until recently, medical teams had to make do with conventional tables, and they had little freedom to move or rotate the patients as needed. One of the most critical pieces of equipment is the operating table. While the planning, done by the medical staff, receives a great deal of media coverage, little attention is typically given to the equipment used during the actual operation. When the twins are joined at the head – craniopagus – the surgery takes on added significance. The thalamus acts like a switchboard relaying sensory and motor signals and regulating consciousness.Surgery to separate conjoined twins is always a delicate operation, characterized by a long period of planning, training and rehearsal before the surgery. Their brains are connected by a thalamic bridge, connecting the thalamus of one with that of the other. The structure of the twins’ brains makes them unique in the world. The vast majority do not survive 24 hours. Krista and Tatiana Hogan were born October 25, 2006, in Vancouver, B.C.Ī CT scan of the twins showed they could never be separated due to the risk of serious injury or death. Here are a few highlights:Ĭraniopagus twins, joined at the head, are a rarity - one in 2.5 million. Still, they are like other Canadian twelve-year-olds they attend school, have a favourite pet and are part of a large, loving family determined to live each day to the fullest. Joined at the head, their brains are connected by a thalamic bridge which gives them neurological capabilities that researchers are only now beginning to understand. BC's Hogan twins, featured in the documentary Inseparable, are unique in the world.
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