Sarnia doc to separate Siamese twins

A Sarnia surgeon is preparing to try a new procedure he's developed to separate Siamese twins joined at the head.

If both twins survive without any complications, Dr. Sanjeev Kaila says it will be a world first and his method would likely be adapted as the standard for such high-risk surgery.

The five-year-old girls, known only as Veena and Vani, are joined at the brain and live in a government hospital in Hyderabad, India. They share the same sagital sinus, a blood vessel on top of the brain responsible for draining blood. However, their brains function independently.

Dr. Kaila met the girls on a trip to India about six months ago and says they are very intelligent and good candidates for separation.

"They both read and write English, which is pretty impressive for age five," he said. "I don't think they have any other option besides separation. I don't think their quality of life will be very good otherwise."

Two of three other attempts to separate twins with a similar condition have resulted in death or severe mental disability for one or more of the patients.

The conventional surgery involves leaving the single sagital sinus blood vessel for one twin and creating a second one with a vein graft.

"The problem is that the child that gets the artificial vessel, gets a second rate vein," Dr. Kaila said. "And it's very intricate, very complex surgery that takes 20 to 26 hours."

He has proposed a completely new approach that relies on technology he sometimes uses for weight-reduction surgery.

In a two-to-three hour operation, Dr. Kaila intends to wrap a hollow rubber band - much like one used to shrink a stomach - around the sagital sinus vein. Over the course of six months, water will be injected into the rubber band so that it very slowly blocks the vein's blood flow.

As that happens, nature will compensate for the loss of the vein by growing two new independent ones, one for each brain, according to Dr. Kaila.

"Our bodies are quite powerful," he said. "We know they adapt over time. I like the Keep-It-Simple-Stupid, or KISS, theory and believe my way is better than going in and cutting the vessel."