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Twin boys successfully separated

Sunday, October 12, 2003

By JAMIE STENGLE

Associated Press Writer

DALLAS (AP) - Two-year-old Egyptian twins joined at the top of their heads were separated Sunday after a marathon surgery that began a day earlier and that took more than a year of planning.

News of the successful separation overjoyed their parents, surgeons and caregivers.

"At one point when someone came up and said you have two boys, the father jumped to my neck and he hugged me and he fainted and I cared for him. He told me that he never dreamt of such a moment," said Dr. Nasser Abdel Al, who was one of the twins' doctors in Egypt and was with the family in Dallas.

"The mother on the other hand was crying like everybody else. She was there thanking everybody around and thanking her faith that brought her to this great place -- Dallas, Texas."

As surgeons worked to finish closing the boys' head wounds Sunday afternoon, part of the medical team held a news conference at Children's Medical Center Dallas to talk about the successful completion of the surgery.

"We're very pleased with the surgical outcome," said Dr. Dale Swift, a pediatric neurosurgeon, "but the post-surgical care is extremely important, really can determine your outcome. So right now we're waiting."

Ahmed and Mohamed Ibrahim, who had an intricate connection of blood vessels but separate brains, were physically separated earlier Sunday, about 26 hours after they entered the operating room. Doctors then went to work covering the head wounds. The entire surgery took 34 hours.

The twins were listed in critical but stable condition. Doctors said the surgery went according to plan. Concerns now include risk of infection and how the wounds will heal.

Dr. Kenneth Salyer, a craniofacial surgeon who founded the World Craniofacial Foundation that brought the boys' here, said his feelings had ranged "from moments of ecstasy to moments of concern and anxiety."

"I always sleep well, not true the nights before this," Salyer said.

Swift described an unexpectedly difficult moment separating the left hemisphere of Mohamed's brain from part of Ahmed's. He said it was too early to tell what kind of neurological damage the boys might have.

After leaving the operating room, the boys will be taken to an intensive care unit, where they will remain in a drug-induced coma for three to five days. Both boys will need additional reconstructive surgery in coming years.

The boys were born June 2, 2001, by Caesarean section to Sabah Abu el-Wafa and her husband, Ibrahim Mohammed Ibrahim. Both were in Dallas for the surgery.

Dallas-based World Craniofacial Foundation, a nonprofit group that helps children with deformities of the head and face, arranged to bring the boys to Dallas in June 2002 for an evaluation.

A team of specialists determined the boys could be separated, though the risks included possible brain damage and death. The boys' father told doctors he felt it was worth it to give them a chance at a normal life.

The fate of the twins has become a talking point in Egypt and the Middle East, where television news stations have been following the progress of surgery.

In the boys' hometown of el-Homr, some 400 miles south of Cairo, villagers have been praying in town mosques for the twins "to return safely," said Mohammed Ibrahim, 65, the twins' grandfather.

"If this is true then this is very good news," Nasser Mohammed Ibrahim, the twins' uncle, told The Associated Press, when told of the separation. "We are waiting for any good news from over there."

But the uncle said he was anxious to have the news, relayed by TV stations in the Middle East, confirmed by his brother and the boys' father, Ibrahim Mohammed Ibrahim.

"I will not rest until I hear my brother's voice," he said. "I'm sure that everyone loves Ahmed and Mohammed, but I can only trust my brother to tell me the news."

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On the Net:

World Craniofacial Foundation: http://www.worldcf.org

Children's Medical Center: http://www.childrens.com

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