Twins Separated by Surgery Ready to Go Home to Germany

BALTIMORE, Md. —  Benjamin and Patrick Binder, the Siamese twins who were born joined at the head and then separated in an unprecedented surgical marathon seven months ago, will be released from the hospital this week to begin what doctors hope will eventually be normal lives, officials said Tuesday.

The 14-month-old boys, who will return to their native West Germany with their parents, still face challenges to develop their speech and motor skills, vision and mental capacities. “Neither child at this point is normal,” said Dr. Mark Rogers of Johns Hopkins Hospital here, where the surgery was performed. Both boys have “the potential for a normal existence,” Dr. Benjamin Carson, a pediatric neurosurgeon at Johns Hopkins, said at a press conference.

A Marvel to Doctors

Doctors who took part in the pioneering 22-hour operation last Labor Day weekend marveled that the brothers--initially given just a 50-50 chance of survival--are alive and progressing well. They called their development remarkable.

Only one in 2 million live births is of twins joined at the head. Several have been surgically separated, but never before had physicians successfully separated twins who shared major blood systems in the brain.

The Binder babies were brought to Baltimore for the delicate procedure after their German physician contacted Rogers at Johns Hopkins, which has a highly regarded pediatric neurosurgery unit.

To carry out the task, a team of 70 specialists lowered the twins’ body temperatures to slow the bleeding and then separated the blood vessels at the backs of the boys’ heads. They used portions of the pericardium, the tissue that covers the heart, to graft new vessels and transplanted skin and back muscle to reconstruct the skulls.

Most Complex Case

“It’s an extraordinary feat . . . just that the children are alive and going home,” Rogers said. He added that he has never seen a case as complex or challenging among the 10,000 children he has treated.

The Binder boys left intensive care in November and are considered to be in stable condition. Each weighs between 25 and 30 pounds.

Their mother, Theresia Binder, 21, is “excited” but also “nervous (and) anxious” about her sons’ return home to Ulm, West Germany, Rogers said. She has visited the boys daily and occasionally has been able to take them out in a stroller. She and her husband, Josef, a factory worker, have sold exclusive rights to the twins’ story to a West German magazine and did not appear at the press conference.

The doctors said that neither Benjamin nor Patrick can walk or crawl and they are behind in verbal development, but have shown improvement.

Further Treatment Set

Benjamin has progressed more rapidly than Patrick, who suffered a setback and was temporarily returned to intensive care several weeks ago after he stopped breathing for about a minute.

Benjamin will return directly home but Patrick will be treated for a short time at a West German hospital for a “reflux” condition, which causes stomach contents to back up into the esophagus.

Dottie Lappe, head nurse in pediatric intensive care at Johns Hopkins, said that “everybody’s going to miss them” at the hospital. Rogers agreed, saying: “We have a tremendous amount of emotional investment (in the children). . . . We had to care for them as physicians and care for them as human beings.”

That care also has meant a substantial financial investment for the hospital and others. Rogers said the hospital has picked up most of the medical expenses, estimated at $800,000, with some help from the German government. The physicians volunteered their services.