The Multidisciplinary Perioperative Management of Conjoined Twin Separation Surgery During the Pandemic

Figures & data

Table 1 Characteristics of Conjoined Twins Managed in Dr Hasan Sadikin National Referral Hospital 2012–2022

Variables	n
Total Number of Subjects	25
Separation Status
Separated	8
Separation planned	2
Non separable	2
Not viable or death < 7 days	13
Type of Conjoined Twins
Omphalophagus	3
Cephalophagus	1
Paraphagus	2
Ischiophagus	3
Thoraco-omphalophagus	13
Others	3
Surgical Status
Separated in-house	7
Both discharged alive	6
One discharged alive	1
Both did not survive	1
Non-separable	11
Non-viable for Life	7
Age on Separation
<1 month	2 (25%)
1–5 month	0
>5 months	6 (75%)
Urgency of Separation
Emergency	2 (25%)
Elective	6 (75%)
Timing of Surgery
Pre-pandemic	5 (62.5%)
Pandemic	3 (37.5%)

Figure 1 Conjoined -Twin Management Team Members.

Figure 2 Preparation for Conjoined twin separation surgery. (A) Note the use of manikin-babies for simulation purposes. (B) Preoperative simulation involving all team members. (C) Media room and spokesperson. (D) Information and technology control room for education, reporting, and information purposes. (E) Two color codes (pink and blue) were used to mark the patients, team members, and equipment.

Figure 3 Conjoined Twins Separation. (A) Anesthesia induction. (B) Surgery, note that the surgical team leader (doctor with glasses) continuously supervises different surgical departments. (C) Twins separated, note that team pink and team blue (marked by colored hair caps) were focused only on one twin each. (D) Pediatric critical care. (E) Discharge meeting with parents, rehabilitation specialist, pediatrics, and social worker. (F) Discharge.