Paediatric Surgery (Ukraine). 2026. 2(91): 120-127. doi: 10.15574/PS.2026.2(91).120127
Ergashev B. B.¹, Khamrayev A. J.², Ismadiyorov B. U.¹, Khamroyev U. A.¹, Abduganiyev A. A.², Urinbayeva N. A.^2
1Republican Educational, Clinical and Methodological Center of Neonatal Surgery at the Republican Perinatal Center, Tashkent, Uzbekistan
²Tashkent State Medical University, Uzbekistan

For citation: Ergashev BB, Khamrayev AJ, Ismadiyorov BU, Khamroyev UA, Abduganiyev AA, Urinbayeva NA. (2026). Experience of separating conjoined twins in the Republic of Uzbekistan. Paediatric Surgery (Ukraine). 2(91): 120-127. doi: 10.15574/PS.2026.2(91).120127.
Article received: Feb 28, 2026. Accepted for publication: Jun 15, 2026.

Aim – to present the clinical experience of the successful surgical separation of conjoined twins fused through the liver, with a description of the preoperative diagnostic assessment, surgical strategy, and postoperative management.
Clinical case. The article presents the successful separation of female Siamese twins from the Republic of Kyrgyzstan (omphalopagus), performed in Uzbekistan at the age of 6 months and 15 days. The examination results revealed that the children were fused through the left lobe of the liver. Each twin has a separate gallbladder. One of the girls exhibits a reversed arrangement of internal organs in the abdominal cavity (situs inversus visceralis). An electrocoagulator, ultrasonic scalpel, argon, and BloodSTOP iX hemostatic material were utilized during the operation. Liver tissue was dissected with an ultrasonic scalpel and electrocoagulator, followed by argon treatment of the exposed liver surface. The total blood loss was approximately 20-25 mL. The children were transferred from the intensive care unit to the neonatal surgery department on the 15^th day post-operation. Thirty days after the operation, both children were discharged home in satisfactory condition.
Conclusion. Surgical separation of conjoined omphalopagus twins fused at the liver is feasible with thorough preoperative assessment of the anatomy of the fusion, meticulous surgical planning, and the use of effective hemostatic techniques. The surgical strategy employed in this case enabled successful separation of the twins with minimal blood loss, preservation of both children's lives, and a satisfactory postoperative outcome. This case represents the first independently performed successful separation of conjoined twins by pediatric surgeons in the Republic of Uzbekistan.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from the child’s parents participating in the study.
The authors declare no conflicts of interest.
Keywords: conjoined twins, omphalopagus, hepatic fusion, surgical separation.

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