Hungarian Surgeon Team Successfully Continues Separating Craniopagus Twins

A total of 14 hours of successful operation was carried out on August 19, 2018, by the team of three doctors from the Hungarian Action for Defenceless People Foundation (cselekves.org).

Dr. Andras Csokay and Dr. Istvan Hudak neurosurgeons with Dr. Greg Pataki plastic surgeon received the invitation last year for the separation of the two-year-old Rabeya and Rokeyah following multiple successful Bangladeshi reconstructive plastic surgery missions led by the Hungarian team.

Siamese twins are born from every 5-6 millionth live births. Attachment at the skull is very rare among them: only 2 to 6% of all cases. The problem can be solved by a very difficult, carefully planned series of operations, the first step of which was successfully completed on February 28, 2018, the separation of the large veins of the brain with an innovative endovascular method that means approaching the area from the inside, from the deep femoral vein.

The second surgery of the two-step endovascular separation of the twins’ brains’ veins, a medical breakthrough, has now taken place. Its unique planning and construction can open new ways of treating cerebral vascular diseases, tumors, and conjoined twins.

During the Hungary-based preparations for the remaining interventions, accurate mapping of the twins’ brains has been made with high-performance computer analysis and 3D modeling, which revealed that there is a possibility of a second vascular obstruction surgery to facilitate final skull separation. This surgery was done by the Foundation’s doctors – once again led by Hungarian neurosurgeon and neuro-intervention specialist Dr. Hudak, in Dhaka Medical College, Bangladesh, with the assistance of local surgeons and anesthesiologists.

The twins will soon be expected to undergo a tissue expander insertion plastic surgery led by Dr. Pataki, which will be followed by the most difficult neurosurgery, the final separation of the brains and reconstruction of the skulls and adjacent tissues.

The doctors hope their activities can serve to further networking between Hungary and Bangladesh.

The series of operations is supported by Interplast Hungary; Hasnat Mia, President of For-Bangladesh Association; Dr. Samanta Lal Sen & Prof. Abul Kalam, National Institute of Burn and Plastic Surgery, Anaesthesiology, Neurosurgery and Cardiology Departments with the administrative support of Director of Dhaka Medical College and Hospital, Bangladesh; Dr. Shazzad Khondoker & Dr. Rayhana Awwal professors of plastic surgery along with all professor of the hospital; Premium Plastic Surgery Budapest; the Hungarian Government; and Sheikh Hasina, Prime Minister of Bangladesh.

Personal information: Dr. Csokay is the leader of the Neurosurgery Department of Military Hospital in Budapest, and Dr. Hudak is a head physician of neuroendovascular surgery in the same hospital. Dr. Pataki is the Head of Premium Plastic Surgery and leader of Pediatric Plastic Surgery Unit of St. John’s Hospital in the capital of Hungary.


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