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StuffedInABoxx t1_jdqr83o wrote

Reply to comment by Kbrew7181 in Rare conjoined twin returns home after successful separation surgery by Sandstorm400

Disclaimer: not a surgeon

Without seeing the case notes, we couldn’t say for absolute certain how complicated this was. However, the liver is a very resilient organ, which is why it would be considered more simple than many other separation surgeries.

You would start with some imaging of the liver. The liver has lobes, so ideally there is a natural separation you use as the guide for your cut. If that’s the case, it is fairly easy. Because it is a shared organ. There will likely be a large vein you would need to tie off and sever, along with numerous smaller vascular structures. There would probably also be some bile ducts to close or reroute, depending on how everything connects in each twin.

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Kbrew7181 t1_jdr2t5a wrote

But I would have to assume that their livers had developed enough that they could be split into two different, fully functioning livers. Sorry, I just hear the term "shared liver" and picture only one liver supporting both of them somehow.

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StuffedInABoxx t1_jdr4lxm wrote

You could think of it as a liver transplant, except the transplanted part of the organ is already in the recipient’s body. With livers, you can transplant a portion and it will still be a functional liver.

There may be some connections that need to be made in other parts of the system like the gallbladder or intestine.

Essentially, it is likely neither twin has a complete liver, they each have a portion of the one liver.

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