Day-long surgery for girl born with eight limbs

Doctors in India are carefully monitoring a two-year-old girl born with four arms and four legs after a marathon operation yesterday to remove the extra limbs.

As the euphoria wore off following the successful completion of the complex operation – in which the team of more than 30 surgeons removed the limbs and reconstructed much of her lower body and internal systems – doctors warned that care must be taken to ensure no complications set in.

"We are still not ready to celebrate as she will be in the critical zone for the next 48 to 72 hours," said Dr Sharan Patil, who led the team at a hospital in the southern Indian city of Bangalore.

Lakshmi, who has been revered by some in her village as the reincarnation of a Hindu goddess, was born joined at the pelvis to a "parasitic twin" that stopped developing in her mother's womb. The surviving foetus absorbed the limbs, kidneys and other body parts of the undeveloped foetus.

Doctors and the girl's parents hope the girl will be able to learn to walk. Without the operation she would not have been able to walk or even crawl. "This girl can now lead as good a life as anyone else," Dr Patil said.

Her father, a labourer from rural northern India, and her mother, who is pregnant again with a healthy foetus, were allowed into the intensive care unit where Lakshmi lay sedated several hours after the surgery, said the hospital's spokeswoman, Dr Patil Mamatha.

"It will be great to see our daughter have a normal body," said her father, Shambhu, who only goes by one name.

Children born with deformities in deeply traditional parts of rural India are often viewed as reincarnated gods. Lakshmi is named after the four-armed Hindu goddess of wealth.

Others sought to make money from the girl. Her parents said they kept her in hiding after a circus apparently tried to buy her.

Doctors worked for more than 24 hours to remove the extra limbs and organs. By midnight, neurologists had separated the fused spines while orthopedic surgeons removed most of the "parasite" twin, carefully identifying which organs and internal structures belonged to Lakshmi, said Dr Patil.

Then began the difficult job of reconstructing Lakshmi's lower body.

The operation included transplanting a good kidney from the twin into Lakshmi. The team also used tissue from the twin to help rebuild the pelvic area in one of the most complicated parts of the surgery, said the team leader.

"Beyond our expectations, the reconstruction worked wonderfully well," Dr Patil said, adding that Lakshmi will not need major reconstructive surgery again. However, he said she will require further treatment and possible surgery for clubbed feet before she will be able to walk.

"This is a very rare occurrence," said Doug Miniati, a paediatric surgeon at the University of California, San Francisco. Dr Miniati, who was not involved in the surgery, said it was extremely complicated but her chances of survival were greater because she was not joined with the twin at the heart or brain.

Doctors at Sparsh Hospital in Bangalore said they performed the surgery for free because the girl's family could not afford it. The physicians estimated its cost at £315,000.

"We are very grateful to all the doctors for seeing our plight and deciding to help us," Shambhu said.