RIYADH: A marathon separation surgery on Syrian craniopagus or conjoined twins was being performed by a multi-disciplinary medical team led by Dr. Ahmed Al-Ferayan in Riyadh on Sunday.

The surgery on the female twins Tuqa and Yakeen was being carried out at the King Abdullah Specialist Children’s Hospital (KASCH) in the King Abdulaziz Medical City (KAMC). It was the fourth and final stage of the operation on the Syrian twins.

The 18-hour surgery, which started at 7.30 a.m. was carried out in four phases, while the microscopic separation of the brains started at 1.30 p.m.

Prior to the operation, Al-Ferayan, consultant neurosurgeon, predicting the success rate of the surgery to be 60 percent. He said the twins underwent a series of medical tests following their arrival to KAMC, some of which was a catheter angiography.

After comprehensively and thoroughly studying the case, the multidisciplinary team concluded that the separation is possible through four stages. The first stage started on June 9, 2014, in which the veins between the twins’ brains were severed and a slice of silicon was inserted between the two brains by Dr. Riyad Alakely. This procedure was successful with no complications. Three month later, the second stage was performed in which the remainders of the veins were separated along with separating a portion of the arteries that carried blood from Tuka’s brain to Aykin’s. This procedure was also successfully conducted with no complications.

The third stage was the most complicated. The third part of the veins and arteries were separated along with a part of the shared brain, and a slice of silicon was inserted between the two brains. The third phase was conducted successfully.

Al-Ferayan said that the multidisciplinary team allocated for the separation covered several disciplines such as pediatrics, anesthesia, plastic surgery, intensive care unit, bursing, as well as neurosurgery that will involve six neurosurgeons — Al Ferayan, Dr. Ahmad Al Oraidi, Dr. Moutasem Azzubi, Dr. Sarmad Al-Karawi, Dr. Ali Bin Salamah from King Saud University and Dr. Dr. Mahmoud Al-Yamany.