Surgery underway to separate twins joined at the head

Neurosurgeons in the U.S. have begun the first of many operations to separate 3-year-old twins who are joined at the head.

The 3-year-old conjoined girls, Tatiana and Anastasia Dogaru, were born in Italy and their parents the Rev. Alin Dogaru, a Byzantine Catholic priest, and Claudia Dogaru, both 31, believe that separating the girls, is their only full chance of surviving.

The top of Tatiana's head is attached to the back of Anastasia's, and they have never been able to look directly at each other; without separation, the twins risk dying in early childhood.

Doctors hope over a 6-month period after a number of complicated operations they will be able to fully separate the two girls.

The twins have been admitted to the University Hospitals' Rainbow Babies & Children's Hospital in Cleveland where doctors had already succeeded in establishing independent blood flow in the twins by inserting small coils into veins in their brains.

The procedure was a prerequisite for the separation surgery.

There is no indication of how long it will take doctors to perform the initial surgery, doctors plan to start at the scalps of the girls, making a wedge where the twins' skulls are joined by removing a rectangular bone flap.

An update on the twin's condition is not planned until tomorrow.

The surgeons have carried out a dummy run on a model in order to insure that they understand the potential problems.

They say how much is achieved in the first operation depends on the complexity of blood vessels, tissue and bone connections.

Bleeding in such procedures is a major risk and other potential complications include infection, stroke and a build up of fluid in the brain.

Craniopagus twins or twins born at the head, are very rare only occurring in 1 in 2.5 million births.

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