Lakshmi Tatma

Infobox Person
name = Lakshmi Tatma


caption = Lakshmi before her 27 hour surgery.
birth_date = 2005
birth_place = Bihar, India
death_date =
death_place =
other_names =
known_for = The viable of a pair of ischiopagus conjoined twins who underwent a successful separation surgery in Bangalore, India.
occupation =

Lakshmi Tatama (Hindi: लक्ष्मी तात्मा = Lakṣmī Tātmā) is an Indian girl born in 2005 in a village in Araria district, Bihar, having "4 arms and 4 legs." She was actually a pair of ischiopagus conjoined twins where one twin was headless due to its head atrophying and chest underdeveloping in the womb. The result looked like one child with four arms and four legs.

Background

Her father, Shambhu, and mother, Poonam were day laborers who earn less than USD$1 per day, and were unable to afford a separation surgery for their daughter. The daughter was named after Lakshmi, the multi-limbed Hindu goddess of wealth. She was sometimes an object of worship as an incarnation of the goddess Lakshmi; when she was 2 years old, she was known all over India. At one point, a circus had offered the couple a sum of money to buy Lakshmi as a sideshow, which forced them into hiding. At the time of being found by Dr. Sharan Patil, she was suffering from an infected pressure ulcer at the neck end of the parasitic twin and continuous fevers.

Lakshmi is their second child. Her older brother is named Mitelesh.

Poonam said in a television program that a few weeks before giving birth to Lakshmi, she had a dream which told her to build a temple to the goddess Lakshmi. Subsequently, Lakshmi was born during the "Festival of Lakshmi". [http://www.cnn.com/2008/HEALTH/conditions/06/19/eight.limbed.girl/index.html]

urgery

Before the operation, while being treated for the ulcer and the fever, she was again sometimes an object of worship as an incarnation of the goddess Lakshmi. She could drag herself around, although impeded by the trailing parasitic twin.

She was the subject of a surgery carried out by Dr. Sharan Patil and 30 other physicians which included Chief Anesthetist Dr. Yohannan John at Sparsh Hospital in Bangalore, India.

The twins' two pelvises formed a single combined ring. Each twin had one working kidney. [Channel 4 UK TV program "Bodyshock: The Girl With Eight Limbs", 9 to 10 pm Tuesday 19 February 2008 and 7 to 8 pm Sunday 24 February 2008] Lakshmi had a second kidney which was necrotic. The autosite's feet were affected by clubfoot.

Her abdominal aorta gave off iliac branches to the autosite's legs and continued as a main trunk artery which gave off iliac branches to the parasite's legs and continued, and finally forked into the parasite's subclavian arteries.

The parasitic twin's spine and abdomen merged with Lakshmi's body. The twins' backbones were joined end-to-end and nerves were entangled. Lakshmi could not crawl normally or walk, but she could drag herself around somewhat. Doctors surmised early on that without the operation, she would not be able to live into her teens. The surgery began on Tuesday, 6 November 2007, at 7 am IST (1:30 AM UTC), and was planned to last 40 hours at the most. An estimated cost of over USD$625,000 was paid entirely by the hospital's charitable wing [http://www.sparshhospital.com/sparsh_foundation.php] Sparsh Foundation. A team of more than 30 surgeons worked in shifts. The surgery lasted for 19 hours. The doctors gave Lakshmi a 75-80% chance of survival during the surgery.

The steps of the operation were:
# (8 hours): Abdominal operation: remove the parasite's abdominal organs.
# Remove the autosite's necrotic kidney and replace it with the parasite's kidney. Tie off the blood vessels that supplied the parasite.
# Move the reproductive system and the urinary bladder into the autosite.
# (6 to 8 hours) Amputate the parasite's legs: this caused heavy bleeding. Cut the joined backbone: the nervous system around the join was found to be extremely chaotic, and care had to be taken to avoid causing paralysis.
# Separation, at 12.30 am on 7th November 2007. The combined pelvic ring was divided through or near the parasite's hip joints and not at the pubic symphyses. The remaining incomplete pelvic ring was cut and bent to make the ends meet, and not left as an open part-circle. [http://www.sparshhospital.com/laxmi_post.php]
# External fixation to hold the parts of the pelvis in place. This caused the pelvis to close in 3 weeks to the normal position.
# (4 hours): Suturing. Operation completed at 10 am on 7 November 2007.

Lakshmi's recovery so far has been swift and satisfactory. Within a week after the surgery, the doctors held a press conference showing Lakshmi being carried by her father. Her feet were still bandaged. She was in the hospital for a month after the operation.

Afterwards, she and her family moved to Sucheta Kriplani Shiksha Niketan [http://www.sksn.org/] in Jodhpur in Rajasthan, where Lakshmi joined a school for disabled children and her father got a job on that school's farm.

As of February, 2008, a later operation is planned to bring her legs closer together. Another operation may be needed to rebuild pelvic floor muscles. [http://news.bbc.co.uk/2/hi/south_asia/7082305.stm]

The last view of her in the television program showed her making an effort to walk, with her thighs fastened together with a spacer to keep her pelvic ring in place while it heals, and casts on her shins and legs.

References

External links

* [http://www.sparshhospital.com/laxmi_post.php Smile of Lakshmi : Rarest of Rare Case] report from [http://www.sparshhospital.com Sparsh Hospital] in India where the operation was performed.
* [http://timesofindia.indiatimes.com/India/Spines_of_2-yr-old_Lakshmi_separated_Doctors/articleshow/2522918.cms Spines of 2-year-old Lakshmi separated: Doctors] Times of India 2007-11-06
* [http://news.bbc.co.uk/2/hi/south_asia/7080326.stm Many-limbed India girl in surgery] BBC News 2007-11-06
* [http://www.cbc.ca/cp/world/071106/w110611A.html Girl born with four arms and four legs undergoes surgery in India] CBC News 2007-11-06
* [http://edition.cnn.com/2007/HEALTH/11/06/india.girl/index.html?iref=mpstoryview#cnnSTCVideo Surgery for girl with eight limbs is going smoothly doctors say] (video) CNN 2007-11-06
* [http://www.cbsnews.com/stories/2007/11/06/world/main3457386.shtml Surgery On Multi-Limbed Girl A Success] (with video and photographs) CBS News 2007-11-07
* [http://www.abcnews.go.com/International/story?id=3831220&page=1 Girl Born With 4 Arms, 4 Legs Has Successful Surgery] (with photographs) ABC News 2007-11-07
* [http://news.bbc.co.uk/2/hi/south_asia/7082305.stm Girl separation surgery a success] (with video) BBC News 2007-11-07
* [http://channel.nationalgeographic.com/episode/girl-with-8-limbs-3966/00 Girl With Eight Limbs]
* [http://ngcblog.nationalgeographic.com/ngcblog/2008/06/ New beginnings for the Tatmas in the land of the Maharajas!]