Marathon surgery on Bangladeshi conjoined twins continues in Melbourne, the first such procedure in Australia
Marathon surgery on Bangladeshi conjoined twins continues in Melbourne, the first such procedure in Australiau00a0 
As people the world over anxiously awaited the outcome and the Pope lead an international prayer vigil at the Vatican, amazing surgery continued at Melbourne's Royal Children's Hospital for the second day this morning to separate Bangladeshi twins Trishna and Krishna, who are conjoined at the head.
"It's going very well," anaesthetist Dr Ian McKenzie told reporters outside Melbourne's Royal Children's Hospital at MiD DAY press-time this morning, 27 hours after the procedure commenced yesterday.
"Basically the kids are going very well, the team's going very well... and they're not separated just yet. It's very fiddly."
Dr McKenzie would not put a time frame on when the twins (they will be three next month) would be separated after their groundbreaking operation began about 8.30am (AEDT) yesterday. Regular bulletins were released by doctors and hospital authorities for viewers of national television breakfast shows this morning.
Australian politicians across the spectrum sent messages of good wishes even as nuns in Dhaka, where the twins were placed by their mother, organised a day of prayer.
In Melbourne, the twin's legal guardian Moira Kelly gave them an emotional goodbye kiss and attended church yesterday along with surgeons battling to save their lives. Their joint guardian Atom Rahmon, who found them in the orphanage 2 u00bd years ago, also waited nervously.
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"It is absolutely incredible. In Bangladesh I would have only given them another week or two live," he said. "Every day for them is a bonus."
After being sedated overnight, Krishna and Trishna were wheeled into surgery at 8.30 am (3 am IST on Monday), where neurosurgeons Wirginia Maixner and Alison Wray took over, cutting into the skull and separating blood vessels and the brain matter that still linked the twins, while retaining enough of the bony bridge to keep the area stable.
A team of 16 neurosurgeons, plastic surgeons, and other medical staff are involved in the groundbreaking procedure, the first in Australia.
"'It's all good news still, it's progressing fantastically, we're still in the phase of the neurosurgical part of it, so the brain is still being separated, but we are getting towards the end of that, we hope,"' a hospital spokesman said this morning.
He said most of the bone had already been separated but there was still a defining bone joining the twins.
Dr McKenzie said surgeons would be operating quite a few hours after the bone was separated.
He said concerns over problems with Krishna's kidney had eased.
The Bangladeshi orphans were given just a 25 per cent chance of making it through the operation without harm. The hospital's experts considered some level of brain damage a 50 per cent chance, and death was also a significant possibility.
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Docs optimistic
However, surgeons were quietly confident yesterday afternoon, saying all the signs so far had been positive.
"Everyone was particularly optimistic and excited," said plastic surgeon Tony Holmes.
Earlier operations to separate blood vessels shared by the twins had been a success with no new major connections appearing.
"If the blood vessels started to reconnect we would end up with pressure problems, but those connections didn't seem to be major,'' Holmes said.
"It's step by step going through it," said the hospital's chief of surgery, Leo Donnan. "You can't speed it up, you can't slow it down."
After the neurosurgeons finished, the plastic surgeons would return, closing the brain lining and skulls with artificial caps, then closing the skin. Work was expected to continue into the day.
Donnan said the teams were used to long hours and complex problems what was new was doing several operations-in-one on two connected patients.
Up to 16 surgeons will come and go during the operation, although only a couple can work at a time.
The biggest unknown would be when the twins' systems were separated for the first time, and their blood pressures stabilised to a new level and their bodies adjusted to a new "dynamic", Donnan said.
After the operation, the children will go to intensive care to minimise any emotional shock of being apart once they wake up.
"They will be nursed in as close an environment as possible because we recognise there is a significant trauma that is going to occuru00a0... they will be kept as close as physically possible," he said.
Brain scans over the following 36 hours will indicate when to make an attempt to wake them. But it could be weeks before it is clear whether the surgery has been a complete success.
(Source: The Age with AAP)
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