Anesthesia for Pygopagus Conjoined Twins During Single-Twin and Simultaneous Pneumoperitoneum: A Case Report

John Paul Sara, Ashley Kydes, Olena Pryjdun, Michael Jacoby, Whitney McBride, Samir Pandya, Samuel Barst

Research output: Contribution to journalArticle


We present the case of the first stage of separation of 9-month-old pygopagus conjoined twins who demonstrated minimal shared vasculature on preoperative imaging and no cross-sedation or cross-neuromuscular blockade during separate inductions of anesthesia. Laparoscopy was implemented in 1 twin at a time, then in both twins simultaneously. Despite insufflation of a single-twin's abdomen, both twins demonstrated hypercapnia and signs of a concomitant respiratory acidosis because of carbon dioxide diffusion through a shared peritoneal membrane. This is the first documented case of simultaneous laparoscopy-induced pneumoperitoneum in pygopagus conjoined twins.

Original languageEnglish (US)
Pages (from-to)71-72
Number of pages2
JournalA&A practice
Issue number3
Publication statusPublished - Aug 1 2018


ASJC Scopus subject areas

  • Medicine(all)

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