Separation of complex pygopagus conjoined twins

Pygopagus twins were born with a unique spectrum of anomalies including a c onjoined distal spinal cord, single kidney (in twin A), single rectum (in t win A), single vagina (in twin B), and severe central nervous system anomal ies in twin B that precluded her independent survival. Separation at 10 wee ks of age was tailored toward Twin A's survival. This report discusses the surgical modifications necessary in view of the unique anatomy, including s alvaging the distal spinal cord and vagina for twin A. Copyright (C) 1999 b y W.B. Saunders Company.