---

'Critical stage' in bid to separate Iranian twins

Neurosurgeons bidding to separate Iranian sisters joined at the head are grappling with rerouting a vein as thick as a finger that helps blood flow through the twins' brains. An international team of five neurosurgeons probed the brains of 29-year-old Ladan and Laleh Bijani as a crucial phase begins in the historic operation expected to last two to four days. "The next 12-24 hours will be a very critical period," Dr Prem Kumar said. The operation at Singapore's Raffles Hospital could kill one or both of the sisters. Surgeons are expected to begin separating the twins' brains this afternoon after encountering unexpected delays cutting through their skulls when the bone turned out to be denser than previously thought, Kumar told a news conference.

"The procedure took six hours - longer than originally expected - because the bones were thick and compact, especially in the areas where the two skull bones fuse," Kumar said.

The shared vein is the biggest obstacle in the surgery: Other than sharing the vein, the women's brains are not joined - though they touch inside their skulls. Their bodies are otherwise distinct. Doctors have removed a vein from Ladan Bijani's thigh and will use that to compensate for diverting the shared vein to one sister's brain. Surgeons worked simultaneously in front of and behind the twins, who are sitting in a custom-built brace connected to an array of lines feeding them intravenously and monitoring their vital signs. "Everything is going according to schedule," plastic surgeon Dr Walter Tan said after making the incisions into the twins' skulls. The twins spent months training at a gym to build up strength for the surgery and Kumar said they could be kept asleep for four days if necessary. An international team of 28 doctors and about 100 medical assistants were enlisted for the surgery. The £190,000 cost of the operation is being underwritten by Raffles Hospital, and the doctors' fees are being waived.

---