Conjoined twins are a rare congenital abnormality with an estimated incidence of 1:50,000 pregnancies and 1:200,000 live births. Pygopagus twins are characterized by sacrococcygeal fusion that is commonly associated with perineal and spinal abnormalities. Management of this complex disease requires a well-developed surgical system with multidisciplinary capacity and expertise.
A decade ago there were no dedicated pediatric neurosurgeons in southern Vietnam. This has changed within a few short years; there are now 10 dedicated pediatric neurosurgeons with continually expanding technical capacity. In August 2017 a multidisciplinary surgical and anesthetic team successfully separated female pygopagus twins with fused sacrum and spinal cord with associated myelomeningocele defect.
The authors present here the first successful separation of pygopagus twins in Vietnam as a representative case of gradual and sustainable pediatric neurosurgical scale-up.
ABBREVIATIONSCH2 = Children’s Hospital 2; LCoGS = Lancet Commission on Global Surgery.
Correspondence Jacob R. Lepard: University of Alabama at Birmingham, AL. firstname.lastname@example.org.INCLUDE WHEN CITING Published online January 17, 2020; DOI: 10.3171/2019.11.PEDS19291.Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.