PETALING JAYA: He had set his mind on a medical career ever since he was a school boy.

       Today, Datuk Dr Zakaria Zahari is the paediatric surgery head at Hospital Tunku Azizah (HTA).

       He was in the news recently when he led an operation to separate the youngest ever conjoined twins in Malaysia.

       The surgery on March 19 came 20 years after his first procedure of separating a pair of conjoined twins. It also marked the 10th such surgery.

       Recounting that historic moment in March – for which the King and Queen sent their congratulations to HTA – Dr Zakaria said, “These were the smallest conjoined twins that we’ve ever done in our department”.

       The pair of 17-day-old twins had weighed just 2.7kg then.

       In an interview with The Star, Dr Zakaria said the surgery had to be done with great precision due to the babies’ age.

       He said that such operations were usually conducted when babies were at least three to six months old – in other words, when they are “more robust” and can withstand a major surgery.

       However, he said the twins had to be separated earlier as they were sharing a liver and had issues with their urine output, with one producing more than the other.

       “We knew then that we had to do something. Otherwise, one baby would do all the work and strain the heart.”

       “Every transplant of a conjoined twin is different.

       “The ones that are complex are those with organs that are joined, as they are more difficult to separate,” he said, adding that twins who are conjoined at the heart cannot be separated.

       Dr Zakaria said after careful consideration and examination, the surgeons, anaesthetists and nurses involved had a major discussion and mock rehearsal to ensure that the surgery would go smoothly.

       “I wouldn’t say that technically the surgery was the hardest but because they were the youngest and the smallest as they were premature, it added another level of difficulty.”

       He said that extra care was needed to conduct the surgery on the premature twins, who were conjoined at their upper abdomen.

       Anaesthesia and blood given to the babies during the procedure had to be accurate to avoid “overloading” the infants.

       The preparation for the operation on the baby boys took about three hours, he said.

       “The babies went into the operation theatre at about 8am and we started the surgery at 11am,” he said.

       “From skin to separation, the procedure was done in 66 minutes. And once we separated them, we completed the surgery within an hour,” he said.

       He said that the surgery became easier when an earlier suspicion that their biliary system and intestines were joined proved false during surgery.

       “As the babies were small, trying to do an imaging or CT scan and being very sure before operating was quite difficult,” he said, adding that the team could only know the babies’ anatomies for certain during the surgery.

       He said after the operation, one of the babies’ condition improved faster than the other.

       They were then separately transferred to Hospital Raja Permaisuri Bainun in Ipoh so that they were closer to their parents who live in Taiping, Perak.

       “Once the babies are bigger, there may be plans to send them back to Hospital Taiping for their continued recovery,” he said, adding that the next step for the babies was to introduce oral feeding.

       Finally taking a rest from work, Dr Zakaria said he is now on a one-week break to celebrate Hari Raya.

       The man, whose passion is in the study of human anatomy, has indeed achieved his aim of becoming a successful surgeon.