It was all very calm: conjoined twins Nima and Dawa separated in Melbourne

\It was all very calm\: conjoined twins Nima and Dawa separated in Melbourne
Conjoined twins: Bhutanese girls separated in six-hour surgery
Mother very relieved after 15-month-old girls from Bhutan underwent surgery at the Royal Childrens hospital

The head of paediatric surgery, Dr Joe Crameri, led the operation and said the best part of the surgery is there were no highs and there were no lows during it. It was all very calm … there was calm discussion and banter, he said.

Nima and Dawa, and their mother Bhumchu Zangmo, arrived in Australia a month ago with the help of an Australian charity, but doctors had delayed the surgery until Friday to ensure the twins were well-enough nourished to support the operation.

The surgery was initially planned for October but was postponed after last-minute checks revealed the sisters were not ready because they needed extra nutritional support.

Conjoined twins who shared a liver are separated in six-hour surgery

The girls were brought to Australia with their mother from Bhutan in October. They were joined at the torso and their livers were joined. But doctors in their home country did not have the surgical experience necessary to carry out the complicated operation.

Conjoined Bhutanese Twins Who Shared Liver Separated In Australia

Mum is very relieved, Crameri said, flanked by his surgical team still dressed in their scrubs. She was very stressed today, it has been a very difficult day for her.

A photograph released by the hospital showed four surgeons carefully lifting one of the twins away from the other on the operating table as the pair began their independent lives.

Video: Conjoined twins Nima and Dawa declared ready for separation surgery on Friday | ABC News

Both girls have had their breathing tubes removed since the surgery which he described as an important and promising step. Neither are in intensive care.

15-month-old Bhutanese twins joined at torso separated after 6 hr surgery in Australia

The Victorian government has offered to pay for the procedure and recovery, expected to cost at least $350,000. Bhutans only paediatrician, who has long been involved in the girls care, travelled to Melbourne to watch the surgery. He acted as a translator throughout the procedure for the girls mother, who spent time praying and meditating.

Doctors were faced with a difficult challenge separating the sisters, as until the first cut, they didnt know how many organs the pair shared. 

Conjoined Bhutanese Twins Who Share Liver To Undergo Separation Surgery

Read more The cost of the flights and accommodation was covered by the Children First Foundation, an Australian-based charity that gives children from developing countries access to specialist surgeries and medical care. More than one-third of people in Bhutan live below the poverty line.

Nima and Dawa, and their mother Bhumchu Zangmo, arrived in Australia a month ago with the help of an Australian charity, but doctors had delayed the surgery until Friday to ensure the twins were well-enough nourished to support the operation.

Conjoined Bhutanese twins separated at Australian hospital , Australia/NZ News & Top Stories

The operation at times involved about 25 medical staff. Earlier on Friday, Crameri told the ABC the challenges of the surgery would depend on where the girls were connected, with the team unsure if they shared a bowel.

Conjoined Bhutanese Twins Separated After More than 20 Doctors, Nurses Complete Surgery in 6 Hours

But on Friday afternoon he said once they were able to successfully separate their livers without compromising their health and access the bowel without impedement the surgery was less complicated.

The girls and their mother spent the past month at a retreat outside Melbourne run by the Children First Foundation, which raised money to bring the family to Australia for the surgery.

He said the next few hours would still remain critical to their recovery. The main challenge would be the healing of wounds.

A photograph released by the hospital showed four surgeons carefully lifting one of the twins away from the other on the operating table as the pair began their independent lives.

We feel quietly confident we will have a good result but as with all post-operative cases we will be closely monitoring things over the coming hours.

Australian surgeons have successfully separated conjoined twins after a tense and lengthy six-hour operation.

Nima and Dawa, and their mother Bhumchu Zangmo, arrived in Australia a month ago with the help of an Australian charity but doctors had delayed the surgery until Friday to ensure the twins were well-enough nourished to support the operation.

Fourteen-month-old twins Nima and Dawa Pelden from Bhutan were admitted to Melbournes Royal Childrens Hospital for the delicate procedure on Friday. 

The girls were known to share a liver, but could also share part of the bowel, which would complicate the surgery, Crameri said, but added that the chance for a successful operation was “looking very positive”.

Operation to separate conjoined twins declared a success

Lead paediatric surgeon Joe Crameri told ABC News the procedure was a success and had been shorter than initially expected and the twins were doing well.

Fourteen-month-old twins Nima and Dawa Pelden (pictured with mother Bhumchu Zangmo) were admitted to Melbourne s Royal Childrens Hospital for the delicate procedure on Friday

He said the operation was expected to last around six hours and would involve 18 medical staff divided into two teams, one for each girl.

After the girls were given the green light on Friday, they were anaesthetised about 8.30am, before a team of four surgeons and about 18 people

We saw two young girls who were very ready for their surgery, who were able to cope very well with the surgery and are currently in our recovery doing very well, Dr Crameri said. 

Conjoined Bhutanese twins undergo separation surgery in Melbourne

The paediatrician said his team was well prepared for the surgery and there werent any complications or major bleeding during the procedure.

Mr Crameri said there was no significant bowel attachments that complicated the procedure and the main challenge was to reconstruct the infants abdomens.

The surgeon said the next 24 to 48 hours would be the most critical for the little girls, but the twins will be closely monitored.

Dr Crameri said the best part of the surgery was that there werent any highs or lows – it was all very calm and quiet with calm conversation,

He said once the team realised they were able to divide the liver successfully without compromising the girls or doing anything fancy to the bowel was a sense of relief.