A sleepy little Lakshmi was wheeled into the operating theater at 0700 hrs in the morning of November 6th 2007. She was anaesthetized and all monitoring equipment was placed, before - following careful preparation - the surgeons began to work. The child was carefully monitored throughout the long surgery and all necessary corrections were carried out immediately throughout the operation.

The pediatric surgery team operated on her first and carefully dissected out vital organs so that they could be preserved during removal of the parasite. Lakshmi's internal structures were not exactly as they had appeared on the scans, but the surgeons were able to negotiate these difficulties. As Lakshmi herself had only one kidney, a second kidney from the parasite was successfully isolated and moved into Lakshmi's body.

Then the neurosurgeons began the delicate process of separating the Lakshmi's spine from the spine of the parasite. This was accomplished without any major complications.

Next the orthopedic team led by Dr Sharan Shivaraj Patil went in to perform the crucial part of the surgery - "the pelvic osteotomy". The bones in Lakshmi's pelvis were split apart in order that they could be moved closer to each other to form a ring, thus supporting Lakshmi's internal organs above. The lack of space caused by the proximity of the parasitic body, and the continuing discovery of unforeseen internal structures, made this a difficult part of the operation. It was also very important that the ring of Lakshmi's pelvis could be closed as tightly as possible in order to give her the best chance of walking in later life. In a daring move, Dr Patil used some of the pelvic bone from the parasitic twin to reconstruct Lakshmi's pelvis into a rounder and more successful shape than had been expected - giving her a very good chance of a normal walking gait later in life.

The climax of the operation at 12.30 am on November 7th. It was a spectacular moment when the legs, arms, and remainder of the parasitic twin were removed from Lakshmi and held in the hands of the Dr Sharan Patil. The Plastic and Micro vascular surgery team then stepped in to perform the soft tissue reconstruction and close the open wound. The whole surgery was completed at 10 am in the morning.

On completion of the surgery, there was a great sense of elation for having achieved everything that the entire team had set out to do. Lakshmi was shifted out to ICU were she is being monitored round the clock. Her condition is stable. But the next 48 to 72 hours are critical. And the whole team is constantly monitoring her in order to ensure that her vital signs remain normal and so that her recovery continues as quickly as possible.

Sparsh Hospital wants to thank the Indian public and people from around the world for their prayers and support without which this landmark surgery would not have been possible. With you we will hope and pray that Lakshmi will continue to make great progress in days and weeks ahead.

Dr Sharan S Patil, Dr Yohannan John, Dr Ashely D'Cruz, Dr Thimappa Hegde, Dr Ashok Koul, and Dr Sanjay Rao from the Sparsh Hospital, Narayana Health City, Bangalore