On Friday, one of the conjoined twins, Jaga was witnessed playing football with hospital staff at AIIMS.
Four-year-old Jagga and Balia who were craniopagus twins, have left for their home in Odisha on Friday as individual human beings after undergoing mammoth head separation surgery at the All India Institute of Medical Sciences.
On Friday, one of the conjoined twins, Jaga was witnessed playing football with hospital staff at AIIMS. Jaga and Balia were admitted at AIIMS on July 14, 2017 as Craniopagus (conjoined twins) where they underwent staged separation of surgeries and separated on October 25, 2017. They'll be shifted to Odisha now.
ANI had reported on September 1 that AIIMS had scheduled to discharge the twins on September 6. The toddlers are travelling via train to their hometown in Odisha along with a team of three doctors and a nurse from AIIMS. In the coming days, both the siblings will be getting medical care at Cuttack Medical College.
Explaining that twins Jagga and Balia are fit to return to their home after two years stay at AIIMS post-surgery, the Union Health Minister Dr Harsh Vardhan said, "It is a proud moment for us that Jagga and Balia are fit and growing healthy after they have undergone series of complex surgeries involved in their head separation. It can be called "AIIMS Delhi Jagga and Balia craniopagus surgery".
"For this, I congratulate doctors and nurses of AIIMS who have done such a mind-blowing work. Last night, when I met their family members, they were so happy to see their children separated. Jagga is so active that he sat on my lap and started playing. We will keep monitoring their health status with SCB Cuttack Medical College in Odisha," Vardhan added.
Co-joined twins, Jagga (Jagganath) and Balia (Balram) were born with fused brain and skull, a condition which is called craniopagus twins. They were born to a tribal mother from Kandhamal district of Odisha. Since their birth, both the children did not have the breastfeeding from their mother, due to uneasiness to each other.
The Craniopagus twins got admitted at AIIMS on July 14, 2017, and thereafter series of discussion and extensive surgical procedures started. This is now claimed as India's first successful separation of Craniopagus twins.
Doctors said craniopagus is a very rare situation. Only 2.5 percent of co-joint twins is craniopagus across the world, out of which only 50 percent of them take birth. Twenty-five percent of such children who take birth die within 24 hours.
On 28 August 2017, the first attempt of the separation surgery was done which lasted for 25 hours. The second stage of surgical separation was done on 25 October 2017.
Professor of neurosurgery, Dr Deepak Gupta, who conducted the marathon separation surgery along with a multidisciplinary team of senior doctors said, "It was not an easy task. Those were restless days and sleepless night, because, it was a surgical separation of two brains. These twins shared not only brains with each other but they also were sharing their blood circulation with each other. For any pediatric neuro-surgeon, it is a once in a lifetime surgery."
"We were apprehensive of a lot of things that children might suffer massive blood loss, cardiac arrest, renal failure, skin expander ruptures, skin grafting failure, infections and seizures during/after the operation. We were prepared for everything. There were many ups and downs. But, we didn't lose our hopes and successfully managed to save Jaga and Balia," said Dr Gupta.
"We planned out the surgery in a very different way. We considered out the venous bypass surgery for these children as they shared blood sinus for outflow from the brain. However, this was technically very challenging but done satisfactorily, he added.
Head of the plastic surgery department, Dr Maneesh Singhal, informed that about 5 skin grafting procedures were done on both the toddlers.
Dr Singhal said, "We also brought the cadaver tissues from Ganga hospital in South India. In the next coming years, we will construct new bones depending upon the status of the brain of the twins."
"For the first time, a 3D brain model was developed which was a true replica of brains of AIIMS TWINS. "Almost a month was spent to get this 3D brain model from the USA. This model was helpful to demonstrate the surgical cleavage planes of the brain needed in this surgery. For one week, we did dry runs because a single wrong cut could have taken their lives," Dr Gupta noted.
Further, Dr Singhal added, "With passing time, both children gradually were weaned off ventilator support systems and life-saving drugs one by one. Jagga recovered earlier than Balia as in previous surgery. "Our entire, team of 125 doctors and paramedics team worked day and night to expedite recovery in these children."
Dr Gupta added, "We have designed customized helmets for them, which kids have to wear. there is no life-threatening condition for them now. They are accepting normal diet by mouth now. Balia however still needs long term rehabilitation care and requires nurture and tender loving care in his activities and feeds.
(With inputs from ANI)
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 "Separated conjoined twin, Jaga, plays with hospital staff in Delhi")
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