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Formerly conjoined twins celebrate separation

 

Formerly conjoined, the Mohamed twins were reunited with Hardy Hendren, MD, who performed their separation surgery five years ago.

hile in the United States with their parents for follow-up care at Children’s Hospital Boston this month, twins Hussein and Hassan Mohamed spent their time like any other 5-year-old boys: playing on the playground, roughhousing with each other, annoying their big brother and becoming unhappy with mom when she says playtime is over.

But these boys were not like most at birth. They were thoraco-omphalo-ischiopagus twins – conjoined twins, attached to each other extensively by the chest, abdomen and pelvis. Their separation required an intricate 25-hour long operation by Hardy Hendren, MD, chief emeritus of Surgery, who has pioneered numerous advances in surgery during his 52-year career.

Hendren performed the first successful separation of conjoined twins in Boston in 1969, and has seen 14 other sets of conjoined twins throughout his career since then. “Every set is a little different from others,” he says. “Conjoined twins have many varieties and no two are just alike. Therefore one has to use considerable judgment and be able to improvise according to the circumstances.”

The Mohamed boys’ surgery five years ago required separating two livers, sorting out the anatomy of the intestines, partitioning the bladder and dividing their single shared colon. “The two Mohamed twins recovered nicely, and returned home, which is the United Arab Emirates,” says Hendren. “All of these complicated cases of conjoined twins require long-term follow-up, and some require additional surgery, thus they returned recently to be re-evaluated and for some slight revisions.”

This trip to Boston, and a previous visit for follow-up care, were far less stressful for parents Fatma and Abdulla Mohamed than the one for the separation surgery when the twins were 4 months old. This time they no longer had to worry about whether the twins would survive or have normal lives. “This is a big difference from the first time,” says Fatma. “Whenever I come back to Children’s I feel happier and more secure.

The boys also enjoy their visits to the hospital and are always excited to go. Even 7-year-old big brother Mohammed told his parents he wished he could have surgery so he could share in the attention his younger brothers have received.

“It’s wonderful to see these little fellows running and playing, full of mischief just like any other 5-year-old boys,” Hendren says. “Their long-term outlook should be good.”

The main issue the Mohameds are worried about now is whether the boys will be able to attend kindergarten when they go back home, since they are struggling with incontinence complications. But the boys are anxious to go. Although they know they were once joined together – and enjoy the attention they receive from their celebrity – they are happy to assert their independence. According to their mother, Hassan is the more stubborn and independent of the two, while Hussein is the quieter twin and “loves his mom.”

“They want to be big and strong like their brother Mohammed,” says Fatma. “They’re up at 6 a.m. playing and fighting. I’m very happy and thankful because prior to the separation I didn’t know if they would survive. Now they are young men.”