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LIVE FROM THE HEADLINES

Interview With Henry Kawamoto

Aired July 4, 2003 - 20:20   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

ANDERSON COOPER, CNN ANCHOR: On Sunday in Singapore, 29-year-old Iranian twins conjoined at the head will undergo surgery to be separated. Now, if the operation is successful, it is going to make history. If not, it could prove deadly. In the last statement before the surgery, the two women wrote, and I quote: "Both of us have started on this journey together and we hope that the operation will finally bring us to the end of this difficult path, and we may begin our new and wonderful lives as two separate persons." Very hopeful indeed. CNN's Dr. Sanjay Gupta has more now.
(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN CORRESPONDENT: Conjoined twins have captured our imagination since the first case was revealed over a thousand years ago. The term Siamese twin is no longer used, but was coined in the 1800s for the Thai born Chang and Eng bunker, arguably the most famous conjoined twins ever. They married sisters, fathered 21 children between them, and toured the world in the circus. After they died, doctors realized that it had only been skin that connected them. Their separation would have been easy.

Today, thanks to modern imaging and advanced operative techniques, even the rarest of the conjoined twins, those connected at the head are being separated. Most recently, the two Maria's from Guatemala underwent a 23-hour operation at UCLA Medical Center in July of last year. Ahmed and Muhammad Ibrahim from Cairo, Egypt, are undergoing evaluation for separation in Texas later this year. Lori and Reba Chappelle are the only adult conjoined twins connected at the head living in the United States. They don't want surgery, and today spend their energy focused on Reba's career as a country music singer.

Those twins conjoined at the head are the rarest, around 1 and 2 million births. But, twins may be conjoined elsewhere on their body more commonly. Up to one in 100,000 births. And now, a thousand years after the first apparent case, medical history will continue. If the operation in Singapore is successful, Ladan and Laleh Bijani will be first adults conjoined at the head to become separated. Dr. Sanjay Gupta, CNN, reporting.

(END VIDEOTAPE)

COOPER: Today's just a remarkable story. Wanted to talk more about, joined now by one of the doctors involved in the operation to separate the two Guatemalan girls last summer. Dr. Henry Kawamoto was the lead plastic surgeon for the procedure at UCLA Medical Center. He joins us live from Los Angeles. Doctor, thanks for being with us. Do these two women have a chance at a normal life?

DR. HENRY KAWAMOTO, PLASTIC SURGEON: I certainly hope so. They're courageous to undergo this operation. And I'm sure the surgeons involved would not attempt it unless they thought there was some chance of them surviving it.

COOPER: Yes. They are just remarkably courageous. I want to read you a quote they wrote in a message to a friend. It says: "We've made our decision to go for the operation. We don't even want to think about the risks. We can't tolerate thinking about that. We are ready for the operation, irrespective of the risks." Bottom line, how risky is this thing, doctor?

KAWAMOTO: Well, it is a risky operation, even for young infants. The mortality rate from the operation itself is about 50 percent. And we know there has been about 39 or 40 done since 1928, actually. And interesting enough, the statistics in terms of mortality have really not improved, despite the fact that we made great advances in medicine.

COOPER: That's fascinating. Now, I understand the riskiest part -- or tell us, what is the risky part at the moment, really, of no return?

KAWAMOTO: Well, it would be at the time when they start separating the blood vessels in the head, because once that is started, there is no return -- point of return.

COOPER: Because these two basically share, my understanding is, the central blood vessel that feeds blood to the heart. Is that correct?

KAWAMOTO: Well, it is a main vessel that drains the blood away from the heart, back -- away from the brain back in towards the heart. And that is a very, very important vessel.

COOPER: Now, the operation that you were involved with, with the two little girls from Guatemala took like 22 hours. I think you thought it would take 12 and it ended up taking 22 hours. This operation, my understanding is, on these two women, could go on for days and is going to involve more than 100 people. How is that even possible?

KAWAMOTO: Well, certainly 100 people, maybe a small estimate. It would be a lot of people involved in this. This group that has attempted this -- that is going to attempt this has tried this in the past, and they had one that, I think, went four or five days. So there...

COOPER: How do you keep going in something like that?

KAWAMOTO: Well, people work in shifts. And you're not there all the time. There are many, many surgeons. That's why you have 100 people there, I guess.

COOPER: I guess so. I guess that's part of the reason. What -- I mean, is there any way to know -- what is the key to survival for these two? I mean, obviously they seem very optimistic and I imagine that is a very good thing to be going into a surgery like this.

KAWAMOTO: Absolutely. And that will mean a lot after the separation occurs, and no doubt it will occur, just depends greatly on how the blood nourishes the brain of each patient there. And that will be the tricky part.

COOPER: I know one of them said they wanted to be a journalist, so let's hope their dreams do, in fact, come true. Dr. Henry Kawamoto, I appreciate you joining us to tell us about this. The operation is on Sunday. We are going to be following this closely on CNN. Thank you very much.

KAWAMOTO: Thank you.

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