It was all very calm: conjoined twins Nima and Dawa separated in Melbourne

\It was all very calm\: conjoined twins Nima and Dawa separated in Melbourne

Conjoined twins: Bhutanese girls separated in six-hour surgery

Mother very relieved after 15-month-old girls from Bhutan underwent surgery at the Royal Childrens hospital

The head of paediatric surgery, Dr Joe Crameri, led the operation and said the best part of the surgery is there were no highs and there were no lows during it. It was all very calm … there was calm discussion and banter, he said.

The surgery was initially planned for October but was postponed after last-minute checks revealed the sisters were not ready because they needed extra nutritional support.

The girls and their mother spent the past month at a retreat outside Melbourne run by the Children First Foundation, which raised money to bring the family to Australia for the surgery.

The girls were brought to Australia with their mother from Bhutan in October. They were joined at the torso and their livers were joined. But doctors in their home country did not have the surgical experience necessary to carry out the complicated operation.

“We saw two young girls who were very ready for their surgery, who were able to cope very well with the surgery and are currently in our recovery doing very well,” he told reporters.

Mum is very relieved, Crameri said, flanked by his surgical team still dressed in their scrubs. She was very stressed today, it has been a very difficult day for her.

Nima and Dawa, and their mother Bhumchu Zangmo, arrived in Australia a month ago with the help of an Australian charity, but doctors had delayed the surgery until Friday to ensure the twins were well-enough nourished to support the operation.

Both girls have had their breathing tubes removed since the surgery which he described as an important and promising step. Neither are in intensive care.

The Victorian government has offered to pay for the procedure and recovery, expected to cost at least $350,000. Bhutans only paediatrician, who has long been involved in the girls care, travelled to Melbourne to watch the surgery. He acted as a translator throughout the procedure for the girls mother, who spent time praying and meditating.

The girls and their mother spent the past month at a retreat outside Melbourne run by the Children First Foundation, which raised money to bring the family to Australia for the surgery.

Read more The cost of the flights and accommodation was covered by the Children First Foundation, an Australian-based charity that gives children from developing countries access to specialist surgeries and medical care. More than one-third of people in Bhutan live below the poverty line.

Conjoined Bhutanese twins separated at Australian hospital , Australia/NZ News & Top Stories

The operation at times involved about 25 medical staff. Earlier on Friday, Crameri told the ABC the challenges of the surgery would depend on where the girls were connected, with the team unsure if they shared a bowel.

The girls were known to share a liver, but could also share part of the bowel, which would complicate the surgery, Crameri said, but added that the chance for a successful operation was “looking very positive”.

But on Friday afternoon he said once they were able to successfully separate their livers without compromising their health and access the bowel without impedement the surgery was less complicated.

He said the next few hours would still remain critical to their recovery. The main challenge would be the healing of wounds.

1:33 Bhutanese conjoined twins to be separated at Melbourne hospital – video The head of paediatric surgery, Dr Joe Crameri, is leading the operation which will involve 18 medical staff. Each girl will be designated a separate team to care for her in theatre, plus nursing and anaesthetic support teams.

We feel quietly confident we will have a good result but as with all post-operative cases we will be closely monitoring things over the coming hours.

The charity previously partnered with the hospital to fund the surgery that separated the Bangladeshi conjoined twins Trishna and Krishna in 2009. The orphaned twins were joined at the head and shared blood vessels and brain tissue. They now live in Melbourne with their adopted family.

Video: Conjoined twins Nima and Dawa declared ready for separation surgery on Friday | ABC News

Doctors were faced with a difficult challenge separating the sisters, as until the first cut, they didnt know how many organs the pair shared. 

Mum said the girls are getting a little bit frustrated with each other, as you would at 14 months, and, like any siblings theyre getting cranky, so mum is really looking forward to the operation happening sooner rather than later, she told reporter last week.

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