Background: The three-dimensional (3D) technique provides with accurate anatomical information. We present the separation surgeries for three different kinds of conjoined twins with the aid of three-dimensional techniques.
Method: For the pygopagus twins, a pelvic and lower vertebral model was made. For the omphalopagus and ischiopagus, their enhanced computed tomography (CT) scan images were transferred to the Computer-Assisted Surgery Planning System (CASP) (Hisense, Qingdao, China) to generate the 3D models.
Result: In the case of the pygopagus twins, the 3D model clearly showed that their coccyges were joined at a 120°angle from each other horizontally which suggested that the blind-end orifice on their back was a pilonidal sinus, which separated the normal sphincter into two halves. In the omphalopagus, the 3D model revealed one of the branches of each twin's hepatic vein was connected with the other's. The 3D model of the ischiopagus twins revealed that both of the twins had duplicated bladders and each baby's duplicated bladders united with one of the bladders of the other baby and a single rectum passing through the middle of the four bladders.
Conclusion: 3D techniques could provide more detailed anatomical information, which is helpful in planning procedures for such complicated separation surgery.
Levels Of Evidence: Level IV.
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http://dx.doi.org/10.1016/j.jpedsurg.2017.06.016 | DOI Listing |
Plast Reconstr Surg
July 2022
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto; and Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children.
Background: Conjoined twinning is a rare medical phenomenon, and numerous challenges remain with respect to surgical separation and reconstruction. The purpose of this study is to present a detailed discussion of the authors' institutional experience with eight conjoined twin separations over the past three decades, focusing on challenges and lessons gleaned from these cases.
Methods: The records of all patients who underwent conjoined twin separation at The Hospital for Sick Children in Toronto, Ontario, Canada, from 1984 to 2018 were retrospectively reviewed.
Adv Skin Wound Care
November 2020
In the Department of Plastic Surgery, Children's Hospital of Fudan University, Shanghai, China, Xiangqi Liu, PhD, MD, is a resident; Jun Li, MD, is Attending Physician; Weijing He, MD, is Attending Physician; Shuai Zhang, MD, is a resident; and Chenbin Dong, PhD, MD, is Chief Attending Physician. Acknowledgments: This project was funded by the Shanghai Municipal Health Commission program (no. 201740061). The authors have disclosed no other financial relationships related to this article. Submitted September 6, 2019; accepted in revised form December 12, 2019.
Background: Conjoined twins are a rare congenital anomaly. If separation of the conjoined organs is feasible, reconstruction of the skin and tissue defects is a challenge for the plastic surgeon. This article describes the use of opposing triangle flaps in the separation of three different kinds of conjoined twins.
View Article and Find Full Text PDFAnn Plast Surg
December 2018
From the Department of Plastic Surgery, Union Hospital, and.
Background: Conjoined twinning is a rare congenital malformation, and the resultant huge body wall defects after separation of conjoined twins represent a real challenge to surgeons.
Methods: From 2004 to 2009, authors performed body wall reconstruction for 2 pairs of thoraco-omphalopagus twins and 1 pair of ischiopagus tetrapus twins. Before separation, the techniques of tissue expansion and tractive training were adopted to acquire sufficient skin for final coverage.
J Plast Reconstr Aesthet Surg
March 2018
Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, PR China. Electronic address:
Background: Repairing body wall defects is a critical step in the treatment of some congenital deformities, and this procedure may need the help from plastic surgeons. Although there are many articles about congenital deformities, body wall defects of these malformations are rarely studied as independent targets.
Methods: In this article, the authors present an LDT classification for congenital body wall defects according to the position of the defects, the tissue layers involved, and the surgical urgency, each of which is represented by letters L, D, and T, respectively.
J Pediatr Surg
April 2018
Department of Orthopedics, Children's Hospital of Fudan University, Shanghai, China.
Background: The three-dimensional (3D) technique provides with accurate anatomical information. We present the separation surgeries for three different kinds of conjoined twins with the aid of three-dimensional techniques.
Method: For the pygopagus twins, a pelvic and lower vertebral model was made.
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