NEW DELHI, 5 October 2005 — US neurosurgeon Benjamin Carson, an expert on separating Siamese twins, is ready to operate on a pair of 10-year-old Indian girls joined at the head if they and their parents give the go-ahead, a member of his team said yesterday.

Carson and his team of 20 specialists, mostly Indians, approved the procedure after studying an angiogram of the twins’ brains at the Indraprastha Apollo Hospital in New Delhi, medical director Anupam Sibal told reporters. But the final decision rests with the parents of the twins — Sabah and Farah Shakeel — who were to return to Patna, capital of the eastern state of Bihar for consultations with friends and family, Sibal said.

The girls’ father, Mohammed Shakeel, told the press conference that he and his family would make their decision at the end of Ramadan. “I am a fatalist. I will leave such things in the hands of Allah,” said Shakeel, who runs a tea stall on Patna railway station. Carson told reporters that while the procedures would be complex and risky, both girls were expected to survive. “If everything goes according to our plan we fully expect them to be alive,” said Carson, head of pediatric neurosurgery at Johns Hopkins Children’s Center in Baltimore, Maryland. “It is our intention that they will both be alive.”

The girls are joined at the head and share a major blood drainage vessel in the brain.

Complicating the procedure is that Farah has two kidneys while Sabah has none and will require a kidney transplant.

The twins, dressed in summer frocks and sporting patterned henna dye on their hands, made a brief appearance at the media conference, held at the hospital, but appeared too overwhelmed to answer questions.

Medical director Sibal was upbeat. “I am delighted to tell you that today is an important moment in Indian medical history when we believe that we can separate Sabah and Farah with a certain degree of confidence,” he said. “We believe that the separation will be possible, that we have the expertise to pull this off.”

The operation would be a five step procedure including one in which they will make medical history, Sibal said.

“Dr. Carson believes we will do something that has never been done before... we will distract the two brains... we will make incisions that will separate parts of the brain, the bony tissue and the lining over the brain.” Sibal said that if the parents give the go-ahead, doctors at the John Hopkins center would create a “virtual 3-D station” of the two brains so that doctors can familiarize themselves with the complexities of the problem.

The next step, he added, would be an occlusion into certain vessels of the brain “by putting in balloons to see if we can recreate other passages” for vascular supply.

Once the third step is over — the separation of the brains — “it will take about three months before we arrive at a fixed date for the actual separation,” Sibal said.

After the twins are separated, yet another operation would be performed in which one of Farah’s two kidneys would be transplanted into Sabah.

Sheikh Mohammad ibn Zayed Al-Nahayan, crown prince of Abu Dhabi, has agreed to pay all the costs for the treatment of the twins.

Carson was the lead neurosurgeon of a 70-member team that successfully separated seven-month-old German twin boys in 1987. In 1997, he and a team of 50 doctors separated 11-month-old Zambian boys, both of whom survived.

The specialist was also a member of at least three other attempts to separate conjoined twins, including the unsuccessful 2003 operation on the 29-year-old Bijani twins from Iran.