Saudi Surgeon Separates His 48th Set of Conjoined Twins

A set of conjoined twins, little boys named Ahmed and Muhammed were successfully separated last month by a remarkable surgeon in Saudi Arabia. They were the 48th set of twins who were operated on by Dr. Abdullah al-Rabeeah, a pediatric surgeon and adviser to the Saudi Royal Court.

For the past 30 years, al-Rabeeah, has run a program that separates conjoined twins born to poor families around the world according to ABC News. The program is housed at the King Abdullah Specialist Children’s Hospital in Riyadh and is funded from royal and Islamic charities. Each case is personally approved by Saudi King Salman and Crown Prince Mohammed bin Salman.

 Patients have come from 21 counties to the kingdom for this remarkable program. “We pay for the travel and expenses,” al-Rabeeah told ABC News. “It has nothing to do with geography, religion or politics. It’s based on science and humanity.”

According to Al-Rabeeah, his program has separated nearly 100 patients with a great success rate. The process of separating conjoined twins who are formed when an egg fails to split completely is very difficult. It depends on where the identical twins are attached and which organs they share. There is only a 1 in 200,000 chance that babies will be born with this condition and many are born stillborn or live only a short time according to the Mayo Clinic. Not all of the twins born can be separated and not all survive.

The most famous pair of conjoined twins were Chang and Eng Bunker who lived from 1811 to 1874. Born in Thailand (Siam), they moved to the US and eventually became exhibited as curiosities at carnivals and sideshows. The term Siamese twins was used to describe the brothers and later was soon to describe all conjoined twins.

Ahmed and Muhammad were born on June 26, 2019 by cesarean section in a small Libyan hospital.  According to ABC News they were conjoined at the abdomen and pelvis and shared bowels, urinary organs, and a third leg. The boys had one surgery in their home country, but the separation surgery was not an option.

The parents who knew before the birth that the boys were to be conjoined but after consideration decided to carry the pregnancy to term. The parent’s made appeals through social media and found al-Rabeeah’s program while searching the internet and the father wrote to the doctor about his sons.

So, I immediately responded to him to provide me with details and reports,” al-Rabeeah told ABC News.

The case was reviewed by al-Rabeeah and his colleagues who then presented it to  the crown prince who, who “immediately directed me to bring them and the government would totally finance them,” al-Rabeeah said.

Upon arrival in Riyadh, the twins undertook a detailed medical evaluation and the team estimated that the surgery would take 14 to 15 hours and would need a team of 35 surgeons and nurses. There was a 30 percent risk of a major complication or loss of life due to the shared organs.

The surgery began at 7:45 am on November 14, 2019. The intestines, bowels, and other internal and external organs had to be separated and the boys shared a pelvis that had to be split but the most emotional part of the surgery is almost at the end.

“In the last two centimeters, there is a silence in the room, and we count from five to zero when the bodies are separated into two,” al-Rabeeah said. “And that moment, the parents are informed, they can see it live. There is a big emotion between all the surgical team that this is the first time when the twins are put on two separate tables for the first time in their lives.”

The parents were thrilled by the outcome. “[The twins’ father] came and tried to kiss my hand. I refused, so he hugged me. And while he’s going to his child, which is Ahmed, he just fell into a big cry. And we have to rub his back and tell him that they’re OK, they’re stable. He said, ‘I’m crying because I’m happy,” al-Rabeeah said.

Ahmed and Muhammed went to the pediatric intensive care unit first and are expected to be in recovery for eight to 12 weeks. The boy’s conditions are stable.

As for the amazing doctor, he went home to have a celebratory dinner with his family. “But I sleep really happy that I have managed to draw a smile on the face of a family that has been under stress and big suffering. For them now to smile … is a really happy feeling,” he said.

Saudi Arabia is commonly thought of as a backwards kingdom where women have few rights. Many people are unaware of the state-of-the-art medical care in places like the children’s hospital or medical skills, and more importantly, the kind heart of Dr. Abdullah al-Rabeeah.