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Sato Y, Iura A, Kawamoto Y, Yamamoto S, Iritakenishi T, Fujino Y. Successful anesthetic management of separation surgery for pygopagus conjoined twins: a case report. JA Clin Rep 2021; 7:6. [PMID: 33404797 PMCID: PMC7788156 DOI: 10.1186/s40981-020-00406-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 11/15/2022] Open
Abstract
Background Conjoined twins are an extremely rare congenital occurrence, and anesthetic management for surgical separation presents unique challenges for anesthesiologists. Case presentation Five-month-old male pygopagus conjoined twins underwent separation surgery. We performed anesthesia induction in the supine position and surgery in the prone position. This presented a challenge because the transition from supine to prone position reversed the positional relationship between the two babies, resulting in crossing of the respiratory circuits and monitors. To solve the problem, we used anesthesia machines and monitors on the opposite side of each baby during anesthesia induction. The positional relationship between the twins and anesthesia machines and monitors normalized after the change to the prone position. Following the separation surgery, the twins were discharged without any complications. Conclusions Our method of using opposite side anesthetic machines and monitors for anesthesia induction was useful for the safe anesthetic management of pygopagus conjoined twins.
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Affiliation(s)
- Yukari Sato
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.,Department of Anesthesiology, Jikei University School of Medicine, 3-19-18 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Akira Iura
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Yu Kawamoto
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Shunsuke Yamamoto
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Takeshi Iritakenishi
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Yuji Fujino
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan
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Hatipoğlu Z, Özden Ö, Bahçeci M, Özcengiz D. Anaesthesia Management of Premature Conjoined Twins with Anal Atresia. Turk J Anaesthesiol Reanim 2019; 47:352-354. [PMID: 31380519 DOI: 10.5152/tjar.2019.12316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/05/2018] [Indexed: 11/22/2022] Open
Abstract
Anaesthesia management of the conjoined twins poses some difficulties both for the anaesthesiologist and the twins. The airway management, presence of cross circulation, hypothermia and positioning are significant points during anaesthesia. We report the anaesthetic management during the colostomy opening of omphalopagus twins with anal atresia, and ultrasound-guided central venous catheterisation.
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Affiliation(s)
- Zehra Hatipoğlu
- Department of Anaesthesiology, Çukurova University School of Medicine, Adana, Turkey
| | - Önder Özden
- Department of Paediatric Surgery, Çukurova University School of Medicine, Adana, Turkey
| | - Mahir Bahçeci
- Department of Anaesthesiology, Çukurova University School of Medicine, Adana, Turkey
| | - Dilek Özcengiz
- Department of Anaesthesiology, Çukurova University School of Medicine, Adana, Turkey
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Nazir Z, Mateen Khan MA, Faruque AV, Dilawar B. Separation of conjoined twins in a resource constraint setting – Lessons learned and implications for global surgery initiatives. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2018.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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