RCH Director of Anaesthesia and Pain Management Dr Ian McKenzie says Krishna and Trishna continue to do well, despite being in theatre for almost 24 hours.

Neurosurgeons are still working hard to separate the girls, but the majority of the brain and bone tissue is now disconnected.  “It’s going better than expected,” he said.

Surgeons had originally predicted the separation would take place around midnight last night or in the early hours of this morning.  Dr McKenzie said the delay is due to neurological damage that the team must painstakingly address.  “It’s very fiddly, we have to be meticulous,” he said.

Krishna’s blood pressure was originally low but as disconnection progresses, her blood pressure has pleasingly continued to rise. Dr McKenzie said they experienced an exciting moment at about 2am this morning when Krishna passed some urine, indicating her struggling kidneys are kicking back in.

Once the neurosurgeons complete the separation, the plastic surgery team will begin closing the layer around the brain and creating a solid gap over parts of the brain where the skull has a deficit.

Dr McKenzie said people should not be concerned about the girls being under anaesthetic for an extended period of time.  “Patients in the Paediatric Intensive Care Unit can be anaesthetised for several weeks at a time.”

He said the main concerns were more mundane, such as ensuring the twins don’t develop pressure ulcers.  Because of the their body shape and the complicated equipment connections they have, “we can’t perform the normal pressure care of rolling them over”, Dr McKenzie said.

But he said the team is positive.

“Their general condition is very good and getting better as they get disconnected.  Some of the things we were worrying about are now in the past.  A lot of the things we were worried about haven’t happened,” he said.

The surgical teams have had organised breaks to rest and refuel.