German Surgeon Told Conjoined Twins No

H A N O V E R, Germany, July 9, 2003 -- The late conjoined Iranian twins always knew their separation could mean death, but the doctor that denied their request for the surgery 15 years ago says they never even had a chance.

Dr. Madjid Samii, president of the International Neuroscience Institute in Hanover, Germany, said he was shocked when he heard the operation onLaleh and Ladan Bijani was set to go forward.

‘They Should Not Be Operated On’

"I was asked in 1988 to evaluate the situation and give my opinion whether this surgery can be done," Samii said. "I tried at that time to convince the people that they should not be operated on."

Samii, 66, said he closely examined the blood supply and blood drainage around their brains and found an insurmountable problem. He says he and his colleagues found the twins shared only one vein that drained blood from their brains to their hearts.

"Blood drainage must be 100 percent when you separate the brain," Samii said. "Otherwise the brain starts to swell and within 24 hours you have increased pressure and then brain death," he said.

Samii, one of the world's leading neurosurgeons, said he assumed the surgeons who decided to operate on the twins must have solved the drainage problem, though he didn't know what their plan was.

The twin Iranian sisters joined at the head since birth 29 years ago died within hours of each other Tuesday after surgeons in Singapore separated them in an operation the twins wanted for years.

The surgical team, led by neurosurgeon Dr. Keith Goh, battled to reroute the shared vein draining blood from the twins' brains to their hearts. Then neurosurgeons pried apart the brains millimeter by millimeter.

The Bijani twins died from massive blood loss after the 52-hour operation.

Samii said he knew there was "no chance of success" all along.

‘I Would Not Support It’

Lori and Reba Schappell, conjoined twins from Reading, Pa., who've been joined at the head since birth 41 years ago, have never considered undergoing a separation procedure, knowing it might be fatal.

Lori Schappell told Good Morning America today that she doesn't believe conjoined twins should alter the way God made them.

"They did not care if they both died," Schappell said. "They wanted to be separated that bad. So to them, you know, that was fine. That was their decision. But I don't agree with it and I would not support it," she said.

Twins joined at the head occur only once in every 2 million live births, and successful separations are extremely rare. A successful separation has never been performed on adults.

Goh, who led a successful similar operation in 2001on infant girls from Nepal, was assisted by Dr. Walter Tan, a plastic surgeon, and Dr. Ben Carson, director of pediatric neurosurgery at Johns Hopkins University in Baltimore.

The twins had said they were willing to risk death for the chance to live separately because of their very different personalities.

Both had law degrees, but Ladan — the more outspoken ofthe two — wanted to be a lawyer in their hometown of Shiraz,while Laleh wanted to be a journalist in Tehran.

Goh said he and his team would "remember them in thebest of times and feel that at least we helped them achievetheir dream of being separated."