Two-year-old Egyptian twins joined at the top of their heads were successfully separated, but face a long recovery after the marathon surgery that lasted 26 hours and took more than a year of planning.
News of Sunday's successful separation of Ahmed and Mohamed Ibrahim 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'd never dreamt of such a moment," said Dr. Nasser Abdel Al, who was one of the twins' doctors in Egypt and 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, part of the medical team at Children's Medical Center Dallas talked Sunday about the successful completion of the surgery.
Ahmed and Mohamed, who had an intricate connection of blood vessels but separate brains, were physically separated 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, and 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 to Dallas, said his feelings had ranged "from moments of ecstasy to moments of anxiety."
Dr. Dale Swift, a pediatric neurosurgeon, said it was too early to tell if the boys would have neurological damage. He said the boys' post-surgical care will be vital to their recovery.
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 parents, from el-Homr, some 645km south of Cairo, were in Dallas for the surgery.
A team of specialists determined in June last year that 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.
On Saturday, 4-month-old twin girls from Greece who were joined at the temple were successfully separated during surgery in Rome. The ANSA news agency said the 12-hour surgery was simplified because the infants didn't share any organs.
Prior to the operations in Rome and Dallas, there had been at least five surgeries around the globe in the past three years to separate twins joined at the head. Three were successful; one resulted in one twin dying and in another both twins died.
The fate of the Egyptian twins has become a talking point there and throughout the Middle East, where television news stations have been following the surgery's progress.
In el-Homr, villagers have been praying in 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, said after learning 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, the boys' father.
"I'm sure that everyone loves Ahmed and Mohammed," he said, "but I can only trust my brother to tell me the news."
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