The picture, which was sent by the family of the twins Tamim and Hamad, show them with their mother, a year after, in Mali.
Doha: One year since conjoined twins Tamim and Hamad were born and several months after they were separated at Sidra Medicine in Qatar, the boys are growing up healthy and beautifully in their home country Mali where they now live normal independent lives.
The twins will be celebrating their first birthday in Mali today. One year on, the team at Sidra Medicine look back fondly and reflects on the case.
“The twins are really doing very well. We have been following up on their progress as we all fell in love with these beautiful and happy little boys. I recently saw a photo of them at home in Mali. They are really grown up, look fantastic and healthy. As one of the lead surgeons, who handled their case, I couldn’t be more happy to see them healthy and thriving,” Dr Mansour Ali, Chair of the Department of Pediatric Surgery told The Peninsula.
Tamim and Hamad were separated at Sidra Medicine in September 2018 and returned home in February 2019.
“Allah sent us to the best place to separate our conjoined children Tamim and Hamad. Despite difficulty and complication, the surgery was conducted very successful at Sidra Medicine. Today, by the grace of Allah, with the help of Sidra Medicine and its team, we are celebrating the first birthday of our twins. They are in good health and living a normal life like any other children of their age,” said Ousmane Ag Mohammed, father of the twins speaking to The Peninsula from Mali.
“I take the opportunity to thank Hamad Medical Corporation for the care provided to the mother during the delivery and Sidra Medicine for making the difficult surgery of separating our conjoined twin successfully,” said Mohammed who shared beautiful photos of Tamim and Hamad being at their home.
The twins’ mother was seen during her 29th week of pregnancy at Hamad Medical Corporation (HMC), while on a visit from Mali to Qatar. After confirming that the twins were conjoined and separation was potentially feasible, a multidisciplinary team from HMC and Sidra Medicine arranged for the delivery and care for the country’s first conjoined twin separation.
The babies were born on May 25, 2018 at HMC’s Women Wellness and Research Centre, prematurely at 33 weeks and five days. They were stabilized and transferred to Sidra Medicine’s Neonatal Intensive Care Unit (NICU) on June 3, 2018.
A full complement of over 150 medical and support staff from across Sidra Medicine – including NICU, surgery, anesthesiology, diagnostic imaging, underwent more than 200 hours of simulation to minimise the risks and improve surgical outcomes.
The first procedure was tissue expansion which was done by plastic surgeons led by Dr Mitchell Stotland on July 24, 2018. Two months later, on September 24, the actual separation surgery took place.
The twins were separated by a team of 10 surgeons and anesthesiologists, led by Dr Mansour Ali and Dr Abdalla Zarroug, during a nine-hour procedure that went without any complications.
“Our job didn’t start or end with the separation surgery. There were dozens of teams involved in ensuring we prepared the babies for both before and after the surgery and this is where our Neonatal ICU and radiology physicians, allied health professionals including dieticians, child life and occupational therapists played a critical role. Not to mention the excellent care provided to the mother and babies when they were first born at HMC. We also ensured the parents were given moral support and guidance by our social care workers. It was an exemplary showcase of multi-disciplinary service and care,” said Dr Ali.
Upon the transfer of Tamim and Hamad a few days after birth from HMC, many important steps of postnatal care were taken by Neonatology, Department of Pediatrics at Sidra Medicine.
The postnatal care included many diagnostic steps, ruling out other malformations, post-surgery ICU care, wound care and occupational therapy, according to Dr Helmut D Hummler, Chief Division of Neonatology, Department of Pediatrics. “During the surgical planning stage, it was diagnosed that vessel connection between the two twins was via the common liver. We scanned to prove that both twins have their own intestinal tract, own gall bladder and biliary system connected to their individual gut systems before our multidisciplinary panel recommended the best approach, time frames and other details to ensure a safe and successful surgery,” he said.
Dr Hummler said that the team at Neonatology, Department of Pediatrics did step wise feeding advancements under close control with the support of speech and language therapists until the twins were ready for full feeds. It allowed both babies to grow and gain enough weight to allow surgery in a more stable condition.
“As every day passed, one of the challenges for nursing and occupational therapy was positioning to keep the babies comfortable and to protect the skin and the common liver as the babies became more and more active,” he added.
In post-surgery ICU care, the babies were given mechanical ventilation and hemodynamic support until they were stable.
“We closely monitored their respiratory status as closure of the abdominal wall can cause increase of intra-abdominal pressure which impairs hemodynamics, kidney function and possibly urine production. This happened in one twin, who had to undergo a separate follow-up operation to decrease the pressure,” said Dr Hummler.
Parenteral nutrition was given via central vein catheters until both infants were able to be fed using their own gastrointestinal tract. “The NICU multi-professional team at Sidra Medicine was delighted to provide the pre and post-operative care for Tamim and Hamad and their parents during their long journey. There were a number of challenges to overcome along their course, and some difficult days, especially in the days and week after surgery when they required a great deal of ‘high tech’ intensive care,” said Dr Alison Bedford Russell, Deputy Chief of Neonatal Clinical Services.
“We are proud to have a team of highly skilled healthcare professionals in NICU who worked together and alongside our surgical team to deliver the highest quality care and meet all their needs. It was lovely to be able to say goodbye to two beautiful boys when they were well enough to leave hospital, and go home with their lovely parents,” said Dr Russell. The twins stayed at Sidra Medicine for nearly five months to ensure that the team at Sidra Medicine could closely monitor their post-surgery recovery and that they would be healthy to travel. They were given the all clear and traveled back to Mali in February 2019.
“The success of this surgery is a testament to the investment made by Qatar in medical services, people and technology that allows a hospital like Sidra Medicine to offer cutting-edge patient and family-centered care. It also establishes Sidra Medicine as a key contender in the region to handle complex pediatric diseases and conditions. This will have a big impact on families who previously travelled abroad to the US and Europe as now Sidra Medicine is attracting international patients to Qatar,” said Dr Ali.
