Thursday, November 19, 2009

Twin awake , talking after epic surgery

Within hours of waking up from a medically induced coma after ground-breaking brain surgery to separate her from her twin sister, Trishna was talking and cuddling her guardian.

"She is talking, she is being Trishna, she's behaving the way she always has, she's fantastic," proud neurosurgeon Wirginia Maixner said.

Ms Maixner, the Royal Children's Hospital's director of neurosurgery, worked for 27 hours with her colleague Alison Wray to separate the conjoined twin girls Trishna and Krishna.

Trishna awoke on Thursday morning and was cuddled and comforted by her legal guardian Moira Kelly, founder of the Children First Foundation, who was instrumental in bringing the twins from Bangladesh to Melbourne for surgery in December 2007.

"She's been cuddling Moira, which is lovely, she's been talking to our speech therapist," Ms Maixner told reporters in Melbourne on Thursday.

"She's just come through major, major, major surgery. It is a huge operation, so she is phenomenally good at the moment."

Krishna was expected to be woken up slowly from her medically induced sleep later on Thursday, Ms Maixner said.

Of the two twins, Krishna will likely take longer to recover as her brain and body have to adjust to new circulation and blood pressure.

"I still anticipate the brain will have a period of time where it will need to readjust so it may be a little bit stormy ahead," Ms Maixner said.

Ms Maixner described her colleague Ms Wray as a "rock" who stood by her side for the entire operation, offering moral and intellectual support and surgical skills.

The operation to separate the twins began about 8.30am (AEDT) on Monday and took 27 hours. Plastic surgeons then worked for another four and a half hours.

The procedure involved a 16-member medical team and incorporated innovative ideas to position the twins on the operating table, making use of custom-designed foam by Clark Rubber.

The two neurosurgeons had to take breaks to allow the twins' brains to "settle" before continuing operating and also needed rest breaks for themselves.

"Sometime in the early hours of Tuesday I looked at Alison and Alison looked at me and I said `I think we've done it', and that was an amazing moment, I have to tell you," Ms Maixner said.

"To have struggled for so long, to have worked so hard for what was not just that day, what was a whole two years of work, to be able to say `I think we've done it'."

But it wasn't until she saw MRI scans of the twins' brains on Wednesday that Ms Maixner breathed her first sigh of relief.

The scans showed that the twins' brains had not sustained any damage during the marathon 31-and-a-half-hour operation.

It was then that Ms Maixner turned, hugged her colleague and did a victory dance.

"I think I did the chicken dance," Ms Maixner said.

"I think Alison and I gave each other a hug. That was actually when we could say we'd done it."

Ms Maixner said the surgery had followed the meticulous plan devised two years ago.

"There wasn't a moment during the surgery where things became critical," she said.

She paid tribute to the entire surgical team, which included neurosurgeons, plastic surgeons and anaesthetists.

Head of surgery Leo Donnan was full of praise for his two female neurosurgeons.

"I've only got one thing to say to them, and that's "girl power".

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