RT Book, Section A1 Waldhausen, John H.T. A1 Hilfiker, Mary A2 Ziegler, Moritz M. A2 Azizkhan, Richard G. A2 Allmen, Daniel von A2 Weber, Thomas R. SR Print(0) ID 1100953234 T1 Conjoined Twins T2 Operative Pediatric Surgery, 2e YR 2014 FD 2014 PB McGraw-Hill Education PP New York, NY SN 978-0-07-162723-8 LK accesssurgery.mhmedical.com/content.aspx?aid=1100953234 RD 2024/03/28 AB There are 8 primary types of conjoined twins. There is a wide variation in anatomy even between these 8 types.Prenatal ultrasound and MRI are useful diagnostic tools. The information gained may help when counseling the family and informing the surgical team in case emergency surgery is needed.Postnatal evaluation depends on the type of twin but should always include an ECHO. Full evaluation allows many (but not necessarily all) of the anatomic issues to be evaluated.Separation is not the only alternative. Not all twins are separable and some parents may not desire separation. All alternatives should be discussed.Surgeons undertaking separation surgeries should be familiar with the literature in order to know how others have dealt with many of the anatomic problems that may be encountered.A team approach to separation is preferable with 1 lead surgeon to coordinate the overall plan of care. Each twin needs his or her own operative team during separation.Planning meetings with all surgeons, nurses, anesthesiologists, and other staff are necessary to help plan and coordinate the separation. Rehearsals may help.Separations may be emergent or elective. In the latter case, separations are most likely to be more successful after 4 months of age.Surgeons should be familiar with the ethical issues surrounding separation and should be prepared to handle attention from the media.Outcome from separation depends on the type of twin but may be excellent. Issues regarding quality of life will vary depending on the type of twin. Surgeons should be able to discuss quality of life concerns with families whether the twins are separated or not.