Surgeons begin marathon task of removing baby girl's second head

Published on Saturday 7 February 2004 00:00

SURGEONS last night began a marathon operation on a seven-week-old girl who was born with two heads, hoping to prevent her from suffering permanent brain damage.

The team planned to spend about 13 hours removing Rebeca Martinez’s second head, which has a partly formed brain, ears, eyes and lips that moved when she was fed.

Eighteen surgeons, nurses and doctors were working in shifts to cut off the undeveloped tissue, clip the veins and arteries and close the girl’s skull using a bone graft from another part of her body.

Rebeca’s parents followed her to the door of the operating room and said a prayer over their baby, holding hands and placing one hand each on her fully formed head.

"Be strong, Rebeca. May God be with you," the girl’s mother, Maria Gisela Hiciano, 26, said.

Yesterday afternoon, the first team started to cut the veins on the outside of the baby’s head. Then they were to go deeper to get to the bone of the undeveloped tissue, and then the risky part - clipping shared veins and arteries and closing the skull with a bone graft from another part of the baby’s body.

"The head on top is growing faster than the lower one," said Jorge Lazareff, the lead brain surgeon and director of paediatric neurosurgery at the University of California at Los Angeles’s Mattel Children’s Hospital. "If we don’t operate, the child would barely be able to lift her head at three months old."

Mr Lazareff said the pressure from the second head, attached on top of the first and facing up, would prevent Rebeca’s brain from developing.

The operation was delayed for about four hours because of complications administering anaesthesia.

"Everything is going as planned. At this point the girl’s not having any problems," said Dr Santiago Hazim, medical director of the Centre for Orthopaedic Specialties in Santo Domingo, where the surgery was being performed.

CURE International, a US-based charity that gives medical care to disabled children in developing countries, is paying an estimated 56,000 for the surgery.

Rebeca’s mother, and father Franklin Martinez, 29, waited with psychologists, away from reporters.

"When the doctors come out and tell us it’s all OK we’ll be filled with happiness," Mr Martinez said before the surgery.

Mr Lazareff, who led a team that successfully separated conjoined Guatemalan twin girls in 2002, was leading the operation along with Benjamin Rivera, a neurosurgeon at the Medical Centre of Santo Domingo and the orthopaedic centre.

Doctors say Rebeca will not need physical therapy and will develop as a normal child if the surgery goes well.

Twins are born conjoined at the head when an embryo splits to make identical twins and then stops growing, leaving them fused. Such twins are rare, accounting for one of every 2.5 million births.

Parasitic twins such as in Rebeca’s case are even rarer. They occur when one stops developing, leaving a smaller, partially formed twin dependent on the other.

Rebeca is the eighth documented case in the world of craniopagus parasiticus, Dr Hazim said.

All the other infants in the documented cases died before birth, making it the first known surgery of its kind, Mr Lazareff said.

He has refused to make a prognosis but said this week that Rebeca’s chances of survival are good.