KOTA KINABALU: A pair of conjoined twin boys, born prematurely and joined at the lower back, have been successfully separated in a complex operation at Sabah Women and Children's Hospital (HWKKS), marking the state's second such medical achievement in less than three months.
The high-risk surgery, performed on Sept 17 when the babies were just 40 days old, had to be brought forward after one of them developed increasing respiratory difficulties.
In a statement, the hospital said the successful operation followed its first separation of conjoined twins on July 2, demonstrating the ability of local specialists to carry out highly complex procedures without transferring patients to Peninsular Malaysia.
"The successful management of two highly complex separation surgeries within such a short period highlights the exceptional commitment, initiative and clinical capabilities of our local medical teams," it said.
The boys were born with a rare condition known as pygopagus, in which they were joined at the lower back, involving the lower spine, sacrum and pelvis.
Their condition was detected during routine antenatal examinations before they were delivered at 32 weeks through an emergency Caesarean section and admitted to the Neonatal Intensive Care Unit (NICU).
Doctors had initially planned to separate them when they were between four and six months old to allow their conditions to stabilise.
However, increasing respiratory support requirements for one of the babies, coupled with the strain on their shared organ systems, prompted the medical team to proceed with surgery earlier than planned.
The operation brought together specialists from HWKKS, Hospital Tunku Azizah in Kuala Lumpur and Sarawak General Hospital.
Paediatric surgeons separated the shared lower intestinal and urinary systems before reconstructing the pelvic floor, creating new anal openings and restoring the urinary passages.
Neurosurgeons also carried out delicate nerve mapping and separation around the sacrum to protect spinal cord function and preserve movement in both babies' legs.
The procedure required close coordination with anaesthesiologists, who maintained the babies' respiratory and cardiovascular stability, while radiologists provided detailed three-dimensional imaging to guide the surgery.
The hospital said the ability to perform such procedures locally was particularly important for premature babies dependent on respiratory support, as it avoided the risks associated with transferring them by air to Peninsular Malaysia.
"Local expertise allows immediate surgical intervention when acute complications arise, while enabling family members to remain by their babies' side throughout the intensive recovery period," it said.
Both babies remain under close observation and are receiving specialised care from the hospital's neonatal intensive care team.
The hospital also expressed appreciation to the specialists, medical officers and nurses involved in the operation.
