AIIMS doctors perform rarest surgery on incomplete parasitic twins feeding on host

By Shalini Bhardwaj
New Delhi [India], February 25 (ANI): A 17-year-old boy, visited AIIMS Delhi in the last week of January with a fully developed lower limb attached to his abdomen that shocked the doctors because he couldn't get the treatment. Since birth, he had lived with this extra limb, which belonged to his underdeveloped twin.
According to Dr. Asuri Krishna, Chief Surgeon, AIIMS Delhi, "This condition is what we call an incomplete parasitic twin. So, it's a twin that has not formed completely but it is feeding on the host."
As the surgery was one of the rarest, the challenge was also high, Dr. Asuri explained, "This surgery is challenging because it is feeding on the host. It derives a lot of his blood supply, his nerve supply, and everything from the host. The challenge is to identify those, and to ligate them and to cut them. And then also we have to see under what all attachment does it have with the abdominal viscera, so whether it's attached to the liver, to the intestine or the colon. So, fortunately, in this patient, there was no major attachment."
"We performed a CT angiography to assess the blood supply to the parasitic limb and found that it was supplied by a branch of the internal mammary artery, which usually supplies the chest wall. This made the situation more challenging. A large cystic mass was also found in his abdomen during the CT scan. After thorough preparation and discussion, his surgery was scheduled for February 8, 2025." he said.
Dr. VK Bansal, Professor, Surgery Department, AIIMS Delhi said, "When we saw the patient coming to our OPD first thing that came in our mind that whether parasitic limb had any connection with the heart or other organs of the body because then surgery would have become more risky and complicated."
On social challenges that the child has faced from birth till 17 years of age, he said, "Throughout his childhood, he faced significant social challenges due to his condition. People often misunderstood him, and he felt isolated, spending much of his childhood alone. He consulted local doctors, but they told him that removing the limb could be fatal because it shared a common heart with him. As a result, he continued to live with the limb. He also struggled with schooling and had to drop out in the 8th grade, unable to return to school since then."
"Finally, a relative suggested he visit AIIMS (All India Institute of Medical Sciences) as a last hope. When he arrived, we admitted him immediately and evaluated him using a team of specialists, including general surgeons, radiologists, plastic surgeons, and anesthesiologists," he said.
Dr. Maneesh Singhal from Burn & Plastic Surgery said, "He recovered quickly after the surgery. He started eating on the first day after the operation, and the drain was removed on the third day. His vital signs remained stable, and he was discharged on the fourth day."
"This successful outcome was not the work of one person but the result of a team effort involving many specialists, including Dr. Asuri Krishna (chief operating surgeon), Dr. VK Bansal, Dr. Sushant Soren, Dr. Brijesh Kumar Singh, Dr. Abhinav Kumar, Dr. Jaymeen Makwana from the Department of Surgical Disciplines, Dr. Manish Singhal and Dr. Sashank from plastic surgery, Dr. Ganga Prasad and Dr. Rakesh from anesthesia, and Dr. Atin and Dr. Ankita from the radiology department," AIIMS Delhi said in a statement. (ANI)