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{{short description|Indian girl (born 2005)}}
{{update|date=July 2016}}
{{Use dmy dates|date=November 2015}}
{{Contains special characters|Indic}}
{{Infobox person
| name = Lakshmi Tatma<br />{{Nobold|{{Lang|hi|लक्ष्मी तात्मा}}}}
| image = Lakshmi Tatma.jpg
| caption = Lakshmi before her 27-hour surgery in 2007
| birth_date = {{birth date and age|df=yes|2005|10|31}}
| 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 Tatma''' is an Indian girl born in 2005 in a village in [[Araria district]], [[Bihar]], with "4 arms and 4 legs." She was actually one of a pair of [[Ischiopagi|ischiopagus]] [[conjoined twins]], one of which was headless because its head had atrophied and chest had not fully developed in the womb, causing the appearance of one child with four arms and four legs. She has undergone surgery to remove these extra limbs.

==Background==
{{BLP unsourced section|date=January 2020}}
Lakshmi's father, Shambhu, and mother, Poonam, were day laborers who earned less than 40 [[rupees]] per day, and were unable to afford a separation surgery for their daughter. The daughter was named after [[Lakshmi]], the [[Hinduism|Hindu]] goddess of wealth (who is depicted as four-armed). The girl was sometimes an object of worship as an incarnation of the goddess; by the age of two, she was known all over India. At one point, a [[circus]] offered the couple money to buy Lakshmi as a [[sideshow]], which forced the family into hiding.<ref>{{Cite web |title=Girl Born With 4 Arms, 4 Legs Has Successful Surgery |url=https://abcnews.go.com/Health/story?id=3831220&page=1 |access-date=2022-06-05 |website=ABC News |language=en}}</ref> At the time of being found by [[Sharan Patil]], the girl was suffering from an infected [[pressure ulcer]] at the neck end of the [[parasitic twin]] and continuous [[fever]]s.

==Surgery==
Lakshmi was the subject of a surgery carried out by [[Sharan Patil]] and 30 other physicians which included Chief [[anesthetist]] [[Yohannan John]] at Sparsh Hospital in [[Bangalore]], [[Karnataka]].

The twins' two [[human pelvis|pelvis]]es formed a single combined ring. Each twin had one working [[kidney]].<ref>[[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</ref> Lakshmi had a second kidney which was [[necrosis|necrotic]]. The [[Parasitic twin|autosite]]'s (Lakshmi herself) feet were affected by [[clubfoot]].

Her [[abdominal aorta]] gave off [[Common iliac artery|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 7:00{{nbs}}a.m.{{nbs}}[[Indian Standard Time|IST]] (01:30{{nbs}}[[Coordinated Universal Time|UTC]]), and was planned to last 40{{nbs}}hours at the most. An estimated cost of over [[United States dollar|US$]]625,000 was paid entirely by the hospital's charitable wing, the Sparsh Foundation. A team of more than 30 surgeons worked in shifts. The surgery lasted for 27 hours and 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 [[Female reproductive system (human)|reproductive system]] and the [[urinary bladder]] into the autosite.
# (6 to 8 hours) Amputate the parasite's legs at the hip joints: this caused heavy bleeding. Cut the joined backbone: the nerves around the joint were found to be extremely chaotic, and care had to be taken to avoid causing [[paralysis]].
# Separation, at 12.30{{nbs}}p.m. on 7 November 2007. The combined pelvic ring was divided through or near the parasite's hip joints and not at the [[pubic symphysis|pubic symphyses]]. The remaining incomplete pelvic ring was cut and bent to make the ends meet, and not left as an open part-circle.<ref>[https://web.archive.org/web/20090206154137/http://sparshhospital.com/laxmi_post.php Lakshmi Tatma: The 40-hour Countdown]. sparshhospital.com</ref>
# [[External fixation]] to hold the parts of the pelvis in place. This caused the pelvis to close in three weeks to the normal position.
# (4 hours): [[surgical suture|Suturing]]. Operation completed at 10:00{{nbs}}a.m. on 7 November 2007.

Within a week of the surgery, 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 in [[Jodhpur]] in [[Rajasthan]], where Lakshmi and her brother joined a school for disabled children and her father got a job at the school's farm.

As of February 2008, a later operation was planned to bring her legs closer together. Another operation may be needed to rebuild her [[pelvic floor]] muscles.<ref>[http://news.bbc.co.uk/2/hi/south_asia/7082305.stm South Asia | Girl separation surgery a success]. BBC News (7 November 2007). Retrieved on 2015-11-22.</ref>

A television program in 2010<ref>''[[Bodyshock]]'' [http://www.channel4.com/programmes/bodyshock/episode-guide], 10{{nbs}}p.m. Thursday 28 January 2010, on [[Channel 4]].</ref> showed her recovering well. It was found that cutting the conjoined vertebral column in the separation operation had not caused [[paralysis]]. She was operated on for [[clubfoot]]. X-rays showed that extra bone between the [[pubic symphysis]] (parts of the parasitic twin's [[ischium]] and [[pubis (bone)|pubis]] bones) had been absorbed, or were not [[ossified]]. Slight [[scoliosis]] was found, but would have to be corrected by a minor operation; her mother was unwilling for her to have to wear a [[spinal brace]] throughout childhood.

==References==
{{Reflist}}

==External links==
* [https://web.archive.org/web/20111221004409/http://articles.timesofindia.indiatimes.com/2007-11-06/india/27981923_1_village-in-araria-district-sparsh-hospital-lakshmi 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://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] [[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

{{Authority control}}

{{DEFAULTSORT:Tatma, Lakshmi}}
[[Category:2005 births]]
[[Category:Living people]]
[[Category:People with parasitic twins]]
[[Category:People from Araria]]
[[Category:Indian children]]
[[Category:Twin people from India]]
[[Category:2005 in India]]
[[Category:2007 in India]]
[[Category:Medicine in India]]
[[Category:Surgical procedures and techniques]]

Lakshmi Tatma - Revision history

UpdateBot at 17:59, 24 June 2022