Perioperative management of separation of pygopagus conjoined twins

Abstract

Perioperative management of conjoined twins is extremely difficult. The unique anatomical and physiological considerations pose a challenge to the entire operating team including the anaesthetist. The complexity of surgical technique, length of operation, risk of hypothermia, changes in fluid, electrolyte and acid-base balance require meticulous planning, appropriate resources and a dedicated team effort. We report successful separation of pygopagus conjoined twins at our institution and discuss the perioperative management.